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Discussion

Question About Fluids and Electrolytes

Hello! I was looking through posts on fluids and electrolytes and found a study guide that LuckyinKY posted. I was going to pm him/her, but it said he/she hasn't been active since March of 2013. So, I figured I would ask you guys!

Here is the link of the post:

https://allnurses.com/general-nursing-student/fluid-amp-electrolytes-518011-page2.html

I was going to attach the study guide too, but I don't have a thing on here to attach documents.

Anyways...in the study guide it talks about electrolyte imbalances and starts off with sodium imbalances. It then goes to discuss hyponatremia. Under "Hypernatremia" it states "Major signs of HYPERNATREMIA are neurologic" and lists some signs. I know that with sodium imbalances you often have mental status changes. So, is it a typo where he/she typed HYPERNATREMIA under the HYPOnatremia area? are major signs of HYPOnatremia and HYPERnatremia neurologic? Or, is it just with HYPERnatremia?

Here is what it looks like on study guide:

Hyponatremia:

  • Sodium deficiency where body fluids are diluted and cells swell from decreased extracellular fluid osmolality
  • Can lead to seizures, coma, and permanent neurologic damage

  • Initial s/s

  • Nausea and malaise

  • As water shifts from the extracellular fluid space to the intracellular fluid space brain cells swell, causing progressive neurologic signs and symptoms, including:

  • Headache
  • Lethargy
  • Confusion
  • Coma

  • Major signs of hypernatremia are neurologic:

  • Altered mental status
  • Neuromuscular irritability
  • Weakness
  • Focal neurologic deficits
  • Seizures and coma

  • Treatment
  • Treatment guided by the underlying cause
    • If volume depleted, Give isotonic infusions
    • Volume overload, Treat with fluid restriction and diuretics
    • If symptoms of hyponatremia are severe: Administer hypertonic saline

Hypernatremia: excess of sodium, less often seen. Can lead to seizures, coma and permanent neurologic damage. -Thirst is the body's main defense against hypernatremia. Drive to respond to thirst is so strong that only people who can't drink voluntarily such as infants confused elderly patients, or unconscious patients

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I think of it as Hypernatremia increases neurological activity leading to restlessness, seizures, irritability and confusion.

Hyponatremia slows down.

Unfortunately both include signs and symptoms of confusion.

I would focus on what s/s are different between the two.

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