Why is my sodium level low
Electrolyte Imbalances | Hyponatremia (Low Sodium)
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hey guys nurse Mike here and welcome to
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guys let's begin today we're wrapping up
hyponatremia hypo meaning low natural
meaning sodium and Emmy up meaning in
the blood so sodium less than 1 3 5
micro equivalents in the blood now main
causes that drain sodium from the body
and into the body we use the 4 DS so
drains like NG tube diuretics diarrhea
as well as diaphoresis profuse sweating
simply all fluids that leave your body
have some type of electrolytes because
we're fluids flow electrolytes go but
the other causes of low sodium we use
the acronym SIADH so the S is actually
SIADH syndrome of ineffective
antidiuretic hormone so if you guys
remember ADH means add D h2o for acronym
now Spanish for yes is C so yes add the
h2o SIADH retains water dilutes sodium
in the blood and so we have this low
liquid e lab values called chemo
dilutions i stands for intoxication of
water so he mode I Lucian again leading
to low sodium those low liquid e lab
values a stands for adrenal
insufficiency is like adrenal crisis
with our Addison's disease patients
basically waste sodium from the body and
puts it in the potty
D is for our diuretics like thiazide x'
and loop diuretics generic names for
hydrochlorothiazide and furosemide both
of these are considered potassium
wasting as well as sodium wasting
diuretics lastly H is for heat
exhaustion or high fever which causes
massive sweating something called
diaphoresis
okay signs and symptoms and nursing
assessments for a low sodium well what's
going on in hyponatremia well it's low
low sodium right and since sodium is the
queen of blood pressure and blood ball
well then everything in the body should
be depressed and deflated right well
wrong it actually depends on the type of
hyponatremia but the two main types are
hypovolemic hyponatremia basically a
loss of fluid and sodium together and
hypervolemic hyponatremia basically an
increase of body water greater than
sodium now before you get too confused
and start reconsidering your career
choice let's make this simple and really
focus in on what the tests will ask you
now what do you really think they're
gonna ask you well prioritization signs
and symptoms of course who are you gonna
assess first so write these down we're
gonna go from mild to severe mild you'll
have fatigue nausea vomiting and
headache medium general malaise or
altered LOC level of consciousness as
well as lethargy or basically weakness
now severe signs that you really have to
prioritize and assess first are seizures
brain stem herniation
coma respiratory arrest which all lead
to death
these are priority signs and symptoms
that your test and your NCLEX will
expect you guys to know they'll ask what
patient will the nurse see first
so guys really pause this video write
those down because honestly they are
very critical now here's a little hint
for you we have NCLEX prioritization and
delegation questions in this next little
video series here at simple nursing calm
so guys please don't worry I got you now
for our general signs and symptoms so in
the heart the cardiovascular system
vital signs will depend on the type of
hyponatremia if we have hypovolemic
basically low low fluid and sodium
you'll have increased heart rate
basically the heart's trying to pump to
provide fluids to the major organs
decrease blood pressure basically not
enough fluid volume and no pressure in
the veins the vascular space increased
respiratory rate because again not
enough fluid hence not enough oxygen and
the lungs are trying to compensate now
on the other side of the coin if you
have hypervolemic high high fluid
increased heart rate because too much
fluid the heart will try to pump harder
to push out that fluid
there'll be increased blood pressure
because of all that fluid in the
vascular spaces and decreased
respirations difficulty breathing due to
that fluid volume overload putting all
that pressure on the lungs as far as
EKGs there'll be cardiac dysrhythmias st
elevations on the ECG because the
ventricles are cramping up and not
relaxing or repolarizing basically not
recharging for the lungs they'll be
shortness of breath and dyspnea known as
difficulty breathing GI nazia vomiting
and abdominal cramping neurologically
your brain and spinal cord you'll have
restlessness and confusion which will
lead to seizures and comas and the
muscles you'll have general weakness so
nursing interventions for at low sodium
hyponatremia so guys what are we gonna
do about it well it's a simple fix
really we just add salt we use actually
the acronym add salts so a we administer
IV saline solution but caution it
depends on what type of hyponatremia we
have if we have hypovolemic hyponatremia
the body has this low low fluid so
isotonic solutions like normal saline or
lactated ringers for hypervolemic
hyponatremia we have high high fluids so
guys we're not gonna give IV fluids
we'll just do water retention and
furosemide are loop diuretics now only
for severe cases in both conditions we
use a very super salty hypertonic
solution like 3% saline it's very very
thick and it puts salt back in your body
very quickly so d stands for diuretics
or dialysis especially true for
hypervolemic hyponatremia that high high
fluid volume so diuretics we'll get all
that extra water out of the body and
into the potty now if your patient's
kidneys are broken like in renal failure
we'll use the back up kidney our
dialysis machine to suck out all the
excess fluids these stands for daily
weights so remember where sodium goes
water flows so infusing a lot of sodium
will cause weight gain
this edema basically making your skin
look like a waterbed so please watch for
that as a nurse S stands for safety our
patients with low sodium have huge risk
for Falls so use fall precautions and
this is pretty much due to orthostatic
hypotension which is that low blood
pressure upon standing so a huge risk
for passing out and falling a stands for
airway precautions so your patient will
be on NPO nothing per oral your patients
probably confused and the last thing you
really need is a choking patient so guys
airway precautions NPO L is for limits
the water intake for patients with
hypervolemic hyponatremia guys they're
already water filled and fluid filled so
stop that water tea is for teach so
foods high in salt like canned foods
processed meats and cheeses anything
packaged or basically the diet of any
normal nursing students but am i right
though uh I'm right there all right
here's a list that students usually
don't think about an end up getting
wrong on their exams salad dressing soy
sauces any type of sauce or seasoning
vegetable juices especially those can
like tomato juices like v8 and even
Chinese foods or cup of noodle soup oh
wait what this oh come on man this is
all I can afford after my tuition I mean
I could be helping a treatment you never
know alright guys that wraps up our
lesson here and we'll see you in the
next video
