MRE-COL-SG-WK1

REAL WORLD READY PROGRAM

SUPLEMENTAL STUDY GUIDE

SEPTEMBER

Subject NCM 105- FLUID & ELECTROLYTES

Topic Electrolytes (Sodium)
Course/Year BSN – 3rd Year
Week Week 6
School Year 1st Semester/AY 2020-2021

I. Objectives

 Determine sources of Na and Cl

 Identify sign and symptoms of excess or deficit in Na and Cl
 Learn Predisposing & Precipitating Factors that causes Hypernatremia,
Hyponatremia

II. Discussion

 Sodium (Na)

Normal Concentration: 136-145 mEq/L

Minimum Daily Intake Requirement:
2g/day

Sources:
 Processed and canned
foods
 Fish and smoked and sausage type foods
 Processed Cheese
 Snack type food

Sodium is an essential electrolyte that helps maintain the balance of water in and around your
cells. It's important for proper muscle and nerve function. It also helps maintain stable blood
pressure levels.

Excess sodium increases blood pressure because it holds excess fluid in the body, and that
creates an added burden on the heart. Too much sodium will increase your risk of stroke,
heart failure, osteoporosis, stomach cancer and kidney disease. And, 1 in 3 Americans will
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 MRE-COL-SG-WK1

develop high blood pressure in their lifetime.

Function:
. Conduction of normal impulses
. Muscular contraction
. Regulates osmotic pressure and therefore volume of ECF

2020 Good Samaritan Colleges

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photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the Good Samaritan Colleges.
o Hyponatremia
A Na deficit in the blood plasma Na level below 135mEq/L

Predisposing Factor:
. Increased Na loss
Precipitating:
1. Renal loss
2. Gastrointestinal
3. Endocrine imbalances
4. Skin fluid losses

. Decrease Na intake
Precipitating:

. Dilutional Hyponatremia
Precipitating:
1. Excessive ingestion of water - water retention; sodium will be
diluted

Diagnostic Test:
. History & Physical Examination
. Serum Na concentration
. Serum Osmolarity

Sign & Symptoms:

. Decrease Bp
. Weak thread pulse
. Oliguria
. Postural hypotension
. Weight gain
. Increase BP
. Pulmonary Edema
. Altered LOC
. Weakness
. Cramps
. Muscle twitching
. Convulsion
. Anorexia
. Diarrhea
. Abdominal Cramps
. Nausea
. Headache
. Irritability
Complications:
- Shock
- Coma
- Co-existing electrolytes deficiency
 Management:
- Prevention (advice px working in hot places to increase na and
water intake)
- Administer prescribed NaCl (NSS iv fluid)
- Restrict H20 intake
- Administer prescribed Diuretics
- Relieve CNS alteration from cellular swelling

o Hypernatremia
Serum level higher than 145 mEq/L

Predisposing Factor:
 Primary Hepernatremia
Precipitating:
1. Infusion of siline water
2. Excessive ingestion of na in diet; na in water
3. Salt water drowning
4. Renal disease
5. Hyperaldosteronism
6. Cushing syndrome
7. Excessive ingestion of water

 Decrease Extracellular H20 resulting in increased Serum Na\

1. Excessive water loss

Sign & Symptoms:

. Thirst
. CNS Alteration
. Dry Flushed skin
. Dry fissured mucous membrane
. Weight loss
. Decreased BP
. Weak Thready Pulse
. Fever
. Vomiting
. Diarrhea

Sign of Severe Hypernatremia:

. Agitated (irritable)
. Restlessness
. Disorientation
. Hallucination

Diagnostic Test:
. History & Physical Examination
. Serum Osmolarity
. Serum Na concentration
. Urine specific gravity

Complications:
. Manic excitement
. Hypovolemia
. Coma
 Management:
 Prevention (restrict the px from na intake)
 Diuretics
 Discontinue Na containing IV fluids
 Renal Dialysis (worst)
 Liberal administration of H20
 Monitor electrolytes for sign of Hyponatremia
 Assess for manifestation of fluid overload
 Assist client while ambulating
(tendency of falling)
 III. Learning Rubric

Instruction: Please read carefully and check the corresponding box for your answer.
(Basahin ng mabuti ang bawat tanong at i-tsek ang kahon ng iyong sagot).

Note: Your honest answers will help us gather accurate data to understand and provide
appropriate interventions for the topic discussed. (Ang matapat na pagsagot ay
makapagbibigay ng tumpak na datos upang mas higit na maunawaan at
makapagbigay ng nararapat interbensiyon patungkol sa paksang ito.)

CONTENT YES MAYBE NO

(2)
(3) (1)
1. I have background knowledge about the topic.
(Mayroon na akong konting kaalaman tungkol sa
paksa.)
2. I can analyze the content to deepen my understanding.
(Kaya kong suriing mabuti ang paksa upang mapalawak pa
ang aking kaalaman.)
3. I can give my own examples.
(Kaya kong magbigay ng sarili kong halimbawa.)
4. I can summarize the content and information that I have
learned.
(Kaya kong lagumin ang paksa at ang kaalamang
aking natutunan.)
5. I clearly understood the topic.
(Lubos kong naunawaan ang paksa ng aralin.)
6. I understand the direction of each activity and answered it
correctly.
(Nauunawan ko ang panuto ng bawat gawain at nasagutan ito
ng tama.)
7. I can enumerate the necessary steps and procedures related
to the lesson.
(Kaya kong hanayin ang mga hakbang at proseso na may
kaugnayan sa paksang tinalakay.)
8. I can independently perform the skill, strategy, or process.
(Kaya kong i-apply ang aking natutunan upang magsagawa
ng isang kasanayan, pamamaraan, o proseso.)
9. I can relate the topic to real-life situations.
(Kaya kong iugnay ang paksa sa totoong
buhay.)
10. I accomplished the task on time.
(Natapos ko ang mga gawain sa itinakdang oras.)