Hyponatremia Case Study

An individual presenting with signs and symptoms of DI will have large volumes of dilute urine excretion, excessive thirst, and possible dehydration. The healthcare provider needs to document that osmotic diuresis is not caused by glucose or another type of kidney disease. If those findings are not the cause of diuresis, continuation of the diagnosis of DI can continue. Usually, a 24-hour urine is observed and documented at the beginning of suspected DI (Grossman & Porth, 2014). Lab work, such as urine and plasma osmolality is very important. In central DI, plasma osmolality will have normal to high levels of sodium (>142mEq/L) due to the significant amount of water loss. When the urine osmolality is less than the serum osmolality, DI is very indicative (Bichet, 2013a). The healthcare provider must look at the urine specific gravity, hematocrit, and sodium levels. In DI, the urine is very dilute and the serum, or blood, is very concentrated. Lab work will reflect a low urine specific gravity and urine osmolality, while the serum sodium and hematocrit will be high. Once central DI is suspected, an MRI of the pituitary-hypothalamic area is used to determine the cause (Grossman & Porth, 2014). According to Grossman and Porth (2014), when assessing an MRI, “a bright-spot is related to the content of stored ADH. This high-intensity signal is present in most

Hyponatraemia is a disorder in fluid-electrolyte stability that results in an unusual low plasma sodium concentration. A continuous decrease in plasma sodium concentration upsets the osmotic balance across the blood-brain barrier, ensuing in an direct entry of water into the brain. This causes brain swelling and a flow of gradually more severe neurological responses such as confusion, seizure, coma which can result in death from break of the brainstem. The faster and lower the blood sodium falls, the greater the risk of life-threatening consequences. (Eichner, 2003). Athletes who drink too much water before and during exercise (high endurance) in warm and humid weather are at a higher risk of developing hyponatraemia. In addition, bigger athletes are not resistant to hyponatraemia but smaller

Polyuria: is more than normal or increased urine output. Water homeostasis is controlled by a complex balance of water intake, renal perfusion, glomerular filtration and tubular reabsorption of solutes, and reabsorption of water from the renal collecting ducts. When intake of water increases, blood volume rises and blood osmolality falls, lowering the release of ADH (arginine vasopressin, which promotes water reabsorption) in the hypothalamic pituitary system. With the lowering of ADH there is a rise in urine volume, which allows blood osmolality to return to normal. Urine containing large amounts of glucose has high osmotic pressure, which attracts water, so that urine output rises (osmotic diuresis).

In Men’s Fitness Magazine, it explains that sodium helps the body hold onto water and helps fluid get to the muscles and blood. Amy Epstein also found that drinking too much water is the cause of hypernatremia, a condition that occurs a lot in athletes who drink a lot of water without the necessary sodium. This can actually cause you to lose fluid (Epstein par. 3-6). Water absorbs quickly into the bloodstream to hydrate the body, but sports drinks absorb even faster because of the minerals contained. Quote

Drinking a large amount of water in a short period of time can be dangerous; it can cause a level of salt, or sodium in your blood to drop too low. This is called “Hyponatremia,” This is a very serious condition that can be fatal. Some symptoms of Hyponatremia are nausea and vomiting, muscle weakness, spasms or cramps, seizures, and loss of energy and fatigue. For serious symptomatic hyponatremia, the first line of treatment is prompt intravenous infusion of hypertonic saline. Untreated overhydration can lead to dangerously low levels of sodium in your blood. This can cause more severe symptoms, such as muscle weakness, cramps, seizures and coma. You would have to drink an enormous amount of water for this condition to happen. But

This will help them plan according to manage times around ADLs and get them more involved with proper medication management. Next, explain the risk of misuse of over-the-counter analgesics, such as NSAIDS, and how they may further reduce kidney function and increase risk for chronic kidney disease. Also, caution the patient about angiotensin-converting enzyme (ACE) inhibitors. ACE inhibitors are commonly prescribed to prevent high levels of protein in urine (proteinuria) and progression of kidney disease, especially in diabetic patients. (Lewis, 2014, pp. 1106-1107) However, Ace inhibitors also have an adverse effect of decreasing perfusion pressure and causes electrolyte imbalance of excessive potassium (hyperkalemia). As a caution, if diet modification, diuretics, and sodium bicarbonate cannot control the hyperkalemia, ACE inhibitors may need to be reduced or

The first test, which may be performed, is referred to as autonomic reflex screening. The screening is composed of three test which ultimately examine the patients blood pressure and heart rate fluctuation in response to the valsalva maneuver. Another test that may be used is referred to as the thermoregulatory sweat tests. The particular pattern an individual sweats can be indicative of a possible neuropathy. Neuropathy is then suggestive that a lesion is present in the nerve causing a fault in the circuitry responsible for maintaining the bodies postural blood pressure.2,16 The last test may be performed to determine the cause of the orthostatic hypotension is a 24 hour urine sodium. This test can be explained by the basic principle of osmosis. Water will always follow in the direction of the sodium or salt. Thus, if the urine sodium is elevated, the kidneys are excreting sodium, as well as, water. If the kidneys are excreting large amounts of water, the plasma volume will be low, contributing to the occurrence of orthostatic hypotension.2,17 A urine excretion of sodium ~17\0 mmol/24 hours is indicative of a normal plasma volume. Using these three screening tests the provider should be able to determine if the cause of the orthostatic hypotension is neurologically related, due to hypovolemia or venous

Before the experiment was conducted, it was thought that the salt solutions would become isotonic with the solutions in the dialysis tubing as the water would enter through the cell membrane in order to lower the concentration of Sodium Chloride and to reverse the effects of Hypernatremia. However, from the results recorded in the second experiment which involved the use of a sports drink known as Staminade, this cannot be seen. For example, on the first day of testing, a dialysis tube from Beaker 1 (5% Salt Solution) weighed exactly 40g. The next day, however, the weight of that same dialysis tube dropped down to 34.5g. This same weight drop can be seen in the other dialysis tubes as well, with one having the initial weight of 39g and ultimately ending up with a mere 15g the next day. The reason behind this weight drop in the dialysis tubing is because the Sodium Chloride is constantly moving in and out of the dialysis tubes trying to create equilibrium where the salt solution within the beaker is isotonic with the solution in the tube. The main problem with this is that the investigation was designed to model how the effects of Hypernatremia could be reversed using osmosis, not diffusion. If the experiment modelled osmosis, then the water

True hyponatremia has a decreased serum osmolality. Osmolality is a colligative property of solutions that depends only on the number of solute particles present in a given volume of solution. The three types of solutes most often encountered in biological fluids are electrolytes, organic molecules, and colloids. Sodium and its counter ions (e.g., chloride [Cl-]) are the major contributors to serum osmolality. The other two principal active osmolar solutes in serum are urea and glucose. The reference interval for serum osmolality in healthy individuals is typically 282–300 mOsm/kg of water (H2O). The most commonly used formula for estimating serum osmolality

Do the necessary investigations such as serum & urine osmolality, urine spot sodium, thyroid function test and serum cortisol levels.

Hyponatremia can develop in patients treated with thiazide type diuretics after many months of treatment. Elderly patients with low body mass and a reduce ability to excrete water load have a higher chance of developing thiazide induce hyponatremia

Dehydration that can be a result not just of poor fluid intake but also of badly managed Type 2 Diabetes Mellitus. Blood

Vomiting and diarrhea cause a number of changes to the body. With the loss of stomach contents, we also see a loss of Hydrochloric Acid (HCl), which in turn contributes to the loss of potassium, or hypokalemia, and loss of sodium, or hyponatremia. The kidneys begin to retain any sodium that is in the collecting ducts by sacrificing hydrogen ions. This helps to prevent loss of potassium by halting the sodium/potassium pump and leads to Metabolic Alkalosis. The loss

White water therapy Practical and inexpensive for the treatment of the disease, with white water therapy do you don't have to take a lot of cost, in addition to white water therapy also gives no harmful side effects to your body. The content in the human body is more than 75% is water, so the water is the most important element in the body. Lack of water may result in the onset of various diseases, for all organs of the body needs water to work. Based on studies of body organs such as heart menusia consists of 75%, the brain consists of 75% of the kidney, consisting of 86%, the blood is composed of 82% and lung consists of 86%. All your vital organs may require sufficient water intake in order to work properly and would have been healthy. But conversely, if the organs are less liquid then it can lead to bad things on your important organ it is.

Water is one of the vital substances on earth and according to Kreger (2004)“Actually, only 1% of the world's water is usable to us. About 97% is salty seawater, and 2% is frozen in glaciers and polar ice caps. Thus that 1% of the world's water supply is a precious commodity necessary for our survival.” All humans on earth need water to survive. A human can go for weeks without food but only 5-7 days without water (Szflarski et al, 2013). When the water in your body is reduced by 1% you become thirsty. Apart from drinking it