What are the treatments for hyponatremia?
- replace sodium through diet/parenteral fluids
- restore normal ECF volume
- restrict water intake
- increase the excretion of water without electrolytes
- correct any other electrolyte losses
What are the treatments for hyponatremia and fluid volume overload?
If fluid volume overload:
- treat/remove underlying cause
- loop diuretic (avoid thiazide diuretics)
- water restriction
What are the treatments of hypernatremia?
- hypotonic solution (0.45% NaCl of D5%W)
- Diuretics: excretion of water and sodium
- DDAVP: desmopressin acetate (treats diabetes insipidus
- Removal of cause (aka meds)
What are the the goals of parenteral solution delivery/ IV administration?
- maintain and meet daily fluid/electrolyte requirements
- replace present/ongoing fluid losses and correct electrolyte imbalances
- act as a diluent for infusion meds
What is the difference of osmolality and osmolarity?
-Osmolarity: the solute concentration of fluids outside the body
-Osmolality: the solute concentration inside the body
(i for inside the body)
What are the mOsm/L of an isotonic solution?
250-375
What are the isotonic solutions? And what is a pt at risk for with isotonic solutions?
- 0.9% NaCl
- D5%W
- LR
- Risk for circulatory overload
What solution is termed half normal saline?
hypotonic solution
What are the mOsm/L of a hypotonic solution?
<250 mOsm/L
What are the hypotonic solutions?
- 0.45% NaCl
- 0.33% NaCl (use with extreme caution/ usually for ICU)
- 2.5% DW
What pt should never receive hypotonic solution?
pt’s with low BP because it will cause more hypotension
What are the mOsm/L of an hypertonic solution?
> 375 mOsm/L
What are the hypertonic solutions?
- D5% in 0.45% NaCl
- D5% in 0.9% NaCl
- D5% in LR
- D10% in Albumin 25%
How should hypertonic solutions always be given?
slowly to prevent circulatory overload
What pt’s are some hypertonic solutions contraindicated?
cardiac and renal disease
