Hyponatremia

• What is the definition of hyponatremia?

  Hyponatremia is < 135 mEq/L sodium.
• What happens to cells when sodium is lost?

  Water shifts into cells, causing swelling.
• What complication can arise from cellular swelling in the brain?

  Cerebral edema can occur from swelling.
• What are common causes of sodium loss?

  • GI losses: diarrhea, vomiting, fistulas, NG suction
  • Renal losses: diuretics, adrenal insufficiency, sodium-wasting kidney diseases
  • Skin losses: burns, excessive sweating, wound drainage
• Why are elderly individuals more susceptible to sodium loss?

  Age-related factors increase their risk of sodium loss.
• What are the age-related risk factors for sodium loss in the elderly?

  1. Decreased thirst mechanism
  2. Reduced kidney function
  3. Frequent use of diuretics
  4. Chronic illnesses
  5. GI issues
  6. Inadequate nutritional intake
• How does a decreased thirst mechanism affect the elderly?

  They may not recognize dehydration and drink less.
• What impact does reduced kidney function have on sodium balance in the elderly?

  Aging kidneys struggle to conserve sodium and water.
• Why do many elderly individuals frequently use diuretics?

  They take diuretics for hypertension or heart failure.
• How can chronic illnesses contribute to sodium imbalance in the elderly?

  Conditions like heart failure can lead to sodium loss.
• What GI issues can exacerbate sodium loss in the elderly?

  Frequent diarrhea, vomiting, or laxative use.
• How does inadequate nutritional intake affect sodium levels in the elderly?

  Poor diet can exacerbate sodium loss.
• What clinical concerns arise from hyponatremia in the elderly?

  • Confusion, dizziness, falls
  • Lethargy, weakness
  • Seizures and coma (if severe)
• What is a key prevention strategy for hyponatremia in the elderly?

  Monitor sodium levels and ensure hydration.
• What should be done if both sodium and water are lost?

  Replace with isotonic fluid for non-severe cases.
• What is the recommended treatment for severe hyponatremia (<120 mEq/L)?

  Use hypertonic solutions for severe cases.
• What should be monitored during rehydration treatment?

  Monitor for fluid volume overload.
• What should be done if sodium is lost with normal-excess fluid?

  Excrete fluid to balance sodium levels.