Hyponatremic Dehydration Patho

Hyponatremic Dehydration 1 Running Head: HYPONATREMIC DEHYDRATION

Hyponatremic Dehydration Elisabeth Fandrich Montana Tech Nursing Department NURS 1566 Core Concepts of Adult Nursing

March 3, 2008 Noel Mathis RN, BSN, MSN

Hyponatremic Dehydration 2

Hyponatremic Dehydration Dehydration is a negative fluid balance in the body. Often dehydration is categorized based on sodium levels. If water and sodium are lost relatively equally, it is called isonatremic dehydration. If more water than sodium is lost, it is called hypernatremic dehydration and if more sodium than water is lost, it is hyponatremic dehydration. Hypernatremic and hyponatremic dehydration only make up about 5% to 10% of all dehydration cases. Hyponatremic dehydration causes intravascular fluid to move into the extravascular spaces because of low serum sodium. The underlying reasons for hyponatremic dehydration are often not known, as was the case with my assigned patient, W,T,3512 . Some common causes of hyponatremic dehydration are less than adequate fluid intake, excessive urine output, diarrhea, vomiting, diuretics, Addison’s Disease, and SIADH (Syndrome of Inappropriate Antidiuretic Hormone). Patients are usually asymptomatic until their serum sodium falls below 125 mmol/L or if sodium levels decline rapidly. As of March 4, 2008, W,T,3512 had a serum sodium level of 127 mmol/L and appeared asymptomatic upon assessment. At that point (125 mmol/L), symptoms that will develop are nausea, lethargy, confusion and headache. In severely hyponatremic patients, seizures, coma, brain damage and death may occur. Diagnoses is based on history and physical as well as labs, most notably, serum sodium. To treat hyponatremic dehydration, the underlying cause (if known) must be treated. 5% dextrose in 0.9% NaCl is used as a replacement fluid. The amount of the sodium in the

Hyponatremic Dehydration 3 replacement fluid is adjusted in order to allow sodium levels to rise slowly. Rapid increase of sodium can cause central pontine myelinolysis (destruction of the myelin sheaths of nerves in the pons resulting in nerve damage).

Hyponatremic Dehydration 4 Sources Ellsbury, MD, FAAP, Dan (March 30, 2006). Dehydration. eMedicine from webMD, Retrieved March 4, 2008, from http://www.emedicine.com/PED/topic556.htm General OneFile (September 21, 2007). Clinical Review: Hyponatremia. GP: 29Gale. Montana Tech Library. Retrieved March 4, 2008, from http://find.galegroup.com/itx/start.do?prodld=ITOF