What is the treatment for - veronica92

[ArchivalUser]

1 mild hypovolumic hypernatremia
2 euvolumic and hypervolumic hypernatremia
3 severe hypervolumic hypernatremia

[ArchivalUser]

just a sec ok ??

[ArchivalUser]

Hypervolemic
Renal failure
Cirrhosis, CHF
Salt, water restriction

[ArchivalUser]

Sorry I was thinking HYPONATREMIA
Euvolemic
SIADH,
Polydipsia
Salt , water restriction

[ArchivalUser]

HYPONATREMIA
Hypovolemic
Diuretics, RTA,ACE
Vomiting, diarrhea, dehydration
Replete volume with normal saline

[ArchivalUser]

regarding hypernatremia this is what i know :
Serum sodium > 145 mEq/L
History/PE :
Oliguria, thirst, weakness, focal neurological deficits, mental status change, and seizures.
Causes :
diabetes insipidus, diuretics, glycosuria
Evaluation : Assess volume status by clinical
Measure urine volume and osmolality.
Treatment :
treat the underlying cause and replace the free water with hypotonic saline.
The deficit should be replaced gradually over 48-72 hours to prevent neurological damage secondary to swelling.

[ArchivalUser]

Jovana you are right but subcategorizing each one of them
1mild hypovolumic hypernatremia....5% saline in .45% dextrose
2 severe hyppovolumic...............isotonic saline
3 euvolumic and hypervolumic hypernatremia..5%DWor oral free water
I am confused about3..could someone elaborate abt condin causing hypervolumic hypernatremia

[ArchivalUser]

Hypervolemic hypernatremia causes:
Iatrogenic (administration of hypertonic Na+ containing solutions (3% NaCl, NaHCO3 infusion, Na+ tablets)
Mineralcorticoid excess (Cushing's syndrome, Conn's syndrome, congenital adrenal hyperplasia)
High renin states

[ArchivalUser]

Principal manifestations involve the CNS - confusion, altered mental status, obtundation, stupor, coma, increased neuromuscular irritability(twitching, seizures)
Intracerebral and subarachnoid hemorrhage may result if shrinkage of brain volume leads to earing of the bridging veins.
Pulmonary or peripheral eema
Respiratory paralysis

[ArchivalUser]

I think you also need to give furosemide (on Hyper-Hyper) to lower hypervolemia but need to be careful to do it slowly (as Jovana said) b/c you don't want to cause more CNS damage