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A fluid restriction diet is generally medically advised for patients with "heart problems, renal disease, liver damage including cirrhosis, endocrine and adrenal gland issues, elevated stress hormones and hyponatremia". [1] Patients with heart failure are recommended to restrict fluid intake down to 2 quarts per day. [2]
Hyponatremia or hyponatraemia is a low concentration of sodium in the blood. [4] It is generally defined as a sodium concentration of less than 135 mmol/L (135 mEq/L), with severe hyponatremia being below 120 mEq/L. [3] [8] Symptoms can be absent, mild or severe.
Almost a century after the pioneering work of Claude Bernard (1813–1878) in animals, Peters et al, in 1950, reported three patients seen at Yale New Haven Hospital with hyponatremia associated with varying cerebral pathologies and severe dehydration. In each patient, urine sodium losses persisted despite hyponatremia and a high-salt diet.
Hypoosmolar hyponatremia is a condition where hyponatremia is associated with a low plasma osmolality. [1] The term "hypotonic hyponatremia" is also sometimes used.[2]When the plasma osmolarity is low, the extracellular fluid volume status may be in one of three states: low volume, normal volume, or high volume.
However, if portion sizes are inadequate, a person may not be consuming enough protein and salt. When combined with excessive water intake, this results in insufficient solute concentration. Patients with poor kidney function, or low glomerular filtration rate, are at even higher risk of hyponatremia due to increased water retention. [2]
Hyponatremia, or low sodium, is the most commonly seen type of electrolyte imbalance. [ 12 ] [ 13 ] Treatment of electrolyte imbalance depends on the specific electrolyte involved and whether the levels are too high or too low. [ 3 ]
Tobacco smoking is an often overlooked factor linked to hyponatremia, due to the ADH-releasing effect of nicotine, although this is usually limited to heavy smokers. [21] One study suggested that around 70% of patients with self-induced polydipsia were tobacco smokers. [22]
The term "cerebral hyponatremia" was suggested in the work of Epstein, et al. 1961. Inappropriate release of endogenous vasopressin is probably responsible for hyponatremia in tuberculous meningitis. Inability to excrete water normally is also a feature of the salt wasting of certain hyponatremic patients with pulmonary tuberculosis.