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Blood results interpretation - Coggle Diagram
Blood results interpretation
U&Es
Sodium
electrical conduction in nerves, skeletal and cardiac muscle
Regulate of water in body
Controlled by various mechanisms
hormonally modulating urinary Na loss (natriuretic pepsides) or down (aldosterone)
Hormonally preventing water loss (ADH aka vasopressin)
Encouraging fluid intake by controlling thirst
Cause
Dehydration
Oedema
Na/K pump
3 Sodium transported out the cell
2 Potassium cells kept in the cell
Kidney anatomy
Distal tubule- 5% na reabsorption (Thiazide diuretics stop the na/cl transporter preventing reabsorption of Na)
Proximal Tubule- accounts for 65-70% Na reabsorption
Ascending Loop of Henle- 25% of na reabsorption (loop diuretics stop Na-K-Cl transporter )
Cotical collecting duct- 2% na reabsorption (Ksparing diuretics prevent Na reabsoption without losing K)
Sodium levels
Hypernatraemia
levels of >145 mmols
S&S
CNS Dysfunction- lethargy, weakness, irritability, myoclonic movement, seizures, confusion
Dehydration and hypovalemia- dry mouth, abnormal skin turgor, oliguria, tachycardia, orthostatic hypotension
Diabetes Insipidus- thirst, polydypsia and polyuria
Cause- inadequate fluid intake, homeostatic mechanisms impaired or overridden due to IVF. Strenuous exercise and Iatrogenic factors eg tube feeding and dialysis
Hyponatraemia
blood levels of less than 135mmol/l
Cause- excess fluid intake
S&S
if mild- headache, nausea, poor balance, inability to think
severe- vomitting, seizures, confusion, coma, cpr arrest caused by RICP and cerebral oedema
Mild- 130-135, moderate 125-129, severe<125
Sodium balance
Liver- Na concentration decreases in liver failure due to increased blood volume
Intestines- Na levels may increase as a result of excess fluid loss in diarrhoea or vomitting
Heart- Na concentration decreases as a result of heart failure due to increased blood volume
Pituitary Gland- SIADH- Na conc decreases. Diabetes Insipidus- Na conc increases
skin- increased sweating- lead to hyper or hypo natraemia depending on na content of sweat and rehydration rate
Kidneys-Na conc increases- excessive urinary output and hyperaldonesteronism
Na conc decreases- excess Na loss or excess fluid gain (kidney disease)
Brain- dementia- thirst impairment-dehydration-increased Na levels