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Hyponatremia

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Hyponatremia is a plasma sodium (Na) concentration of ≤135 mEq/L. Hyponatremia itself does not provide information about the “total body water (TBW)” state of the patient. Patients w...

DIAGNOSIS

  • Symptoms related to the rate of fall in serum Na and the degree of hyponatremia

  • Mild (serum Na 130 to 135 mEq/L): usually asymptomatic

  • Moderate (serum Na 120 to 130 mEq/L): nausea, vomiting, m...

TREATMENT

GENERAL MEASURES

  • Assess all medications patient is taking.

  • Institute seizure precautions.

MEDICATION

ALERT

Rapid correction of severe symptomatic hyponatremia has been associated with central pon...

ONGOING CARE

DIET

  • Euvolemic hyponatremia: Restrict water to 1 L/day.

  • Hypervolemic hyponatremia: water and Na restriction

PROGNOSIS

  • In hospitalized patients, hyponatremia is associated with an elevated ris...

REFERENCES

1
Singh TD, Fugate JE, Rabinstein AA. Central pontine and extrapontine myelinolysis: a systematic review. Eur J Neurol.  2014;21(12):1443–1450. [View Abstract on OvidMedline]
2
Rozen-Zvi...

ADDITIONAL READING

  • Abraham WT, Hensen J, Gross PA, et al; for the LIBRA Study Group. Lixivaptan safely and effectively corrects serum sodium concentrations in hospitalized patients with euvolemic hypo...

SEE ALSO

Algorithm: Hyponatremia 

CODES

ICD10

E87.1 Hypo-osmolality and hyponatremia 

ICD9

276.1 Hyposmolality and/or hyponatremia 

SNOMED

  • 89627008 Hyponatremia (disorder)

  • 267447008 Hypo-osmolality and or hyponatremia

  • 74185008 Hyponatremia w...

CLINICAL PEARLS

  • Alcohol-dependent individuals with vitamin deficiencies, elderly women taking thiazide diuretics, and people with hypokalemia or burns are at increased risk of central pontine myelinol...

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