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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