NURS 3100 Study Guide - Final Guide: Chemoreceptor Trigger Zone, Bowel Obstruction, Irritable Bowel Syndrome
Document Summary
Excess na loss: sweat, gi, ssri, diuretics, aceis, ecstasy. Na dilution: na free parenteral solutions, psychogenic polydipsia (excess water intake, increased adh, saidh (syndrome of inappropriate adh, hyperglycemia, prostate surgery. May be: hypovolemic, euvolemic, hypervolemic, may be acute or chronic. Drop in sodium concentration in ecf: water flows from ecf to icf compartment, cells become swollen. Inc nerve cell water impaired sensorium (confusion, lethargy, + romberg sign, seizures, coma) More dangerous than hypernatremia because of potential for hernias. Acute: risk of brainstem herniation if na+ <120 meq/l: inc. na+ rapidly by 4-6 meq/l over 1-2 hours with 3% saline then stop saline*, hypotonic is 0. 9% !! Chronic: risk of cerebral pontine myelinolysis (cpm) if rapid correction attempted !!: hypovolemic: isotonic saline (slow. 0. 5meq/l/hr) or water restriction, inc. dietary na+** Decreased extracellular water esp: inc. water loss, decreased water intake from impaired thirst or unconsciousness. Increase in sodium concentration in ecf: water flows from icf to ecf compartment, cells shrink.
