NURS 3100 Study Guide - Final Guide: Supersaturation, Hyporeflexia, Gentamicin
Document Summary
Increased nerve cell water impaired sensorium (confusion, lethargy, +romberg sign - if patient were to come eyes and try to stand and they can"t maintain posture, seizures, coma) Increase antidiuretic = not make as much urine fluid in intravascular space and dilution of urine: how is hyponatremia treated? (consider acute versus chronic hyponatremia. ) 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. Low sodium level = rapid replacement over a brief time. Risk of cerebral pontine myelinolysis (cpm) if rapid correction attempted !!! Hypovolemic: isotonic saline (slow 0. 5meq/l/hr) or water restriction, inc. dietary na+ Be careful not replacing sodium too quickly. Normal brain cells exposed to hypotonic environment water gain within nerve cells flux of electrolytes moving stabilize sodium within vasculature disrupt sodium balance overall. Rapid rate of electrolyte diffusion disrupts organic disruption affect myelin tissue (no myelin, can"t transmit nerve signal)
