Anesthesia Central is an all-in-one web and mobile solution for treating patients before, during, and after surgery. This collection of drug, procedures and test information is derived from Davis’s Drug, MGH Clinical Anesthesia Procedures, Pocket Guide to Diagnostic Tests, and MEDLINE Journals. Explore these free sample topics:
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First Things First (assess & treat for the following)
- Hyponatremia is defined as a plasma sodium concentration < 135 MEq/L.
- It is present in 6-22% of general hospital patients but in as many as 30% of ICU patients and is a significant predictor of mortality.
- Is the hyponatremia real?
- Laboratory error: repeat test
- Spurious hyponatremia: blood drawn from vein w/ infusing hypotonic IV solution
- Is pt symptomatic?
- Most pts are asymptomatic.
- Severity of signs & symptoms depends on rapidity of onset and absolute decrease in plasma sodium concentration. Major clinical manifestations are neurologic and are due to acute brain swelling or cerebral edema.
- Symptoms of hyponatremia: Headache, lethargy, apathy, confusion, disorientation, muscle cramps, anorexia, nausea, agitation
- Signs of hyponatremia: abnormal sensorium, depressed deep tendon reflexes, Cheyne-Stokes respiration, hypothermia, pathologic reflexes, seizures, stupor, coma
- What is the pt’s volume status?
- DIAGNOSIS: Hyponatremia is not a disease but a manifestation of variety of disorders. The underlying cause can often be ascertained from a careful history and physical examination, including the assessment of ECF volume and effective intravascular volume status.