Need help w/ nursing diagnosis for pt w/ hyponatremia on fluid restrictions

[madameflychica]

Need help with nursing diagnosis please!

Pt is hyponatremic on fluid restrictions. She is always thirsty and is always requesting water. She is always eating so my nursing intervention is to educate her on eating smaller meals and less snacks. Another intervention I have is to give her gum/hard candies to alleviate her thirst sensations. What would be a nursing diagnosis for this? Thanks!

[WogM]

sodium affects the brain.... people with sodium imbalances often are confused and act crazy so....

"risk for injury related to confusion secondary to hyponatremia" is a good one and some nursing interventions could be to ensure safety measures are taken.... bed in low locked position, side rails up, call light within reach, patient instructed to call us for assistance.

another dx could be "risk for falls related to confusion secondary to hyponatremia" with some of the same interventions.

water follows sodium so "risk for imbalanced fluid volume related to dehydration secondary to hyopnatremia". some interventions could be to encourage fluid intake (as possible with restrictions), record I&O Q shift

hope that helps

[bhanson]

Candy is hyperosmotic and will make them even more thirsty. Use ice chips instead although remember that x volume of ice chips is roughly equal to about x/2 volume of fluid.

[tonyakingo32]

do anyone have any more intervention and rationale on hyponatremia? need help completing a care plan:sniff:

[PNicholas]

I recommend getting a careplan book that also has a cd. It really helps me when I have trouble finding the correct diagnosis. I have one called Nursing Care Plans Diagnosis, Interventions, and Outcomes. It saves me a ton of time. Sometimes, it also helps if I can go bigger with my diagnosis. As in, what is causing the hyponatremia. Sometimes this works and sometimes it doesn't. Hope this helps! :)

[art1stic]

risk for fluid overload r/t hyponatremia

risk for increased intracranial pressure r/t hyponatremia

admin demeclocycline, sodium tab, ice chips

fluid restrictions

monitor I/O, sodium blood levels, s/s of hyponatremia, check urine(color, urine specific gravity etc)

check for edema, neuro checks, monitor for signs of ICP, s/s of fluid overload

anticipate to report levels to MD, and continue to monitor effectiveness of said therapy.

outcome: pt will have sodium levels between 135-145

no need to tell her to stop eating, promotes wound healing, edema will further induce skin break down(if pt has edema)

[nurseprnRN, BSN, RN]

"water follows sodium so "risk for imbalanced fluid volume related to dehydration secondary to hyopnatremia". some interventions could be to encourage fluid intake (as possible with restrictions), record i&o q shift"

exactly backwards. hyponatremia is indicative of water excess, not de-hydration (and not, with very rare exceptions, sodium losses). indeed, a good way to become hyponatremic is to chug a lot of plain water (or have someone give you a couple of liters of d5w intravenously, basically plain water once the dextrose gets metabolized, which is quickly), thus diluting the sodium you have on board.

common in psych units, also seen in adolescents who think chugging water in groups until somebody vomits is safer than chugging alcohol. it's not. the effect of hyponatremia is that water travels into the cells, thus causing cellular edema. especially bad in places with no place for swelling to go, like inside the skull. fatalities are not unheard of.

people with hyponatremia/water excess are almost always on strict free water restriction.

while treating low sodium level with a goal of normalizing it is part of the medical plan of care, you can certainly include the assessment for nursing interventions for safety and other outcomes in your nursing plan of care.