Hyponatremic Dehydration 2Hyponatremic DehydrationDehydration 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 calledisonatremic dehydration. If more water than sodium is lost, it is called hypernatremicdehydration and if more sodium than water is lost, it is hyponatremic dehydration.Hypernatremic and hyponatremic dehydration only make up about 5% to 10% of alldehydration 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 thecase with my assigned patient, W,T,351
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. Some common causes of hyponatremicdehydration are less than adequate fluid intake, excessive urine output, diarrhea,vomiting, diuretics, Addison’s Disease, and SIADH (Syndrome of InappropriateAntidiuretic 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,351
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had a serum sodium levelof 127 mmol/L and appeared asymptomatic upon assessment. At that point (125mmol/L), symptoms that will develop are nausea, lethargy, confusion and headache. Inseverely 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
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