Question

discuss what conditions elevated levels and decreased levels of the electrolyte may cause in your patients. What interventions would you expect for elevated and decreased levels of the electrolyte?

• Sodium

Answer 1

The normal serum value for sodium, the most abundant cation in extracellular fluid, is 135 to 145 mEq/L. Sodium is the primary determinant of extracellular fluid osmolality, so it has a principal role of controlling water distribution and fluid balance throughout the body.

Hyponatremia - A serum sodium level below 135 mEq/L is considered hyponatremia. This condition can be due to low levels of sodium or to excess water in relation to the amount of sodium, sometimes referred to as dilutional hyponatremia. Some common causes of hyponatremia include profuse diaphoresis, draining wounds, excessive diarrhea or vomiting, trauma with significant blood loss, low sodium intake, hormonal changes associated with Addison disease or hypothyroidism, and overuse of thiazide diuretics. Low sodium levels may be seen in patients with aldosterone deficiency due to adrenal insufficiency and in patients diagnosed with the syndrome of inappropriate secretion of antidiuretic hormone. Hyponatremia is also a common electrolyte imbalance in postoperative patients.

Hypernatremia -  hypernatremia is an excess of sodium concentration in serum (levels above 145 mEq/L). It's generally associated with a hyperosmolar state where a fluid volume deficit exists, although it also can exist in normal fluid volumes with excess sodium ions. The increase in extracellular sodium causes intracellular fluid to shift out into the extracellular space, causing cellular dehydration. Some common causes of hypernatremia include inadequate water intake or excessive fluid loss, administration of tube feedings and other high solute solutions without adequate water supplements, diarrhea, and excessive steroid use. Medical conditions associated with hypernatremia include hyperaldosteronism, Cushing syndrome, diabetes insipidus, and renal failure. Administration of hypertonic saline solutions or excessive use of sodium bicarbonate may also cause hypernatremia.