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- Na Cl BUN
- -------l-----------l---------< Glucose
- K CO2 Scr
What's the normal Na range? What is it called below this range? How low must it be to become a major health issue?
135-145 mEq/L normal range
<120mEq/L requires medical attention
What's the normal range for K?
When do we start medical treatment?
3.5-5.0 mEq/L is normal range
- <3.0 is the beginning of the moderate range and where we begin treatment
- <2.5 is start of severe trouble range
What is the normal lab range for Cl?
What's the regular lab value range for CO2?
What is a normal fasting glucose range?
70 – 110 mg/dL
What's a normal BUN (blood urea nitrogen) range?
What's the normal serum creatinine range?
0.7 – 1.5 mg/dL
What are signs and symptoms of hyponatremia at <120mg/dL?
agitation, anorexia, apathy, disorientation, muscle cramps, nausea, depressed deep tendon reflexes, and seizures
What 5 things regulate Na in the body?
antidiuretic hormone (ADH); renin-angiotensin-aldosterone system; and natriuretic factor (ANF) => renal glomerular filtration rate and sodium reabsorption/excretion
What are the 2 main causes of hyponatremia?
- 1. Na depletion in excess of total body water.
- 2. Dilution hyponatremia where water intake is much greater than output
CHF, liver disease, and renal failure all tend to cause which kind of hyponatremia?
What would be a typical treatment of this?
Na depletion in excess of total body water
Na and water restrictions, diuretics
Dilution hyponatremia can be due to what? (5 examples given)
- Primary SIADH, renal failure
- Drug induced (thiazide diuretics)
What are the signs and symptoms of hypernatremia?
What lab values indicate hypernatremia?
Thirst, restlessness, irritability, muscle twitching, seizures(both hyper and hypo so must look for other symptoms), coma, death
Which occurs more often, hypernatremia or hyponatremia?
Which one is likely more dangerous to the patient?
hypernatremia for both questions
What would be a standard treatment for hypernatremia?
D5W or 1/4NS for about 24hrs
What are the 3 types of hypernatremia?
- Low total body sodium - loss of water and sodium, but greater water loss
- Normal total body sodium - water loss and redistribution, sodium same
- High total body sodium - exogenous administration of Na (rare)
CPR using Sodium Bicarbonate, IVs with >0.9NS, swallowing sea water, and dialysis involving Na solutes could cause what?
hypernatremia (high total body sodium)
Fever or extensive burns could cause what related to Na?
hypernatremia (normal total body sodium)
Is Na an intra or extracellular cation?
What about K cation?
What K lab range would indicate hypokalemia?
At what range should treatment begin?
At what range is it considered in severe need of medical help?
<3.0mEq/L (beginning of moderate range)
<2.5mEq/L (beginning of severe range)