Disorders of electrolytes and water and acid–base balances



| |University of Mosul |

| |College of Pharmacy |

| | |

|Disorders of electrolytes and water and acid–base balances |

| |

| |

| Dr.Saad Kleman Abd |

3ed Year

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Hyponatremia; is serum sodium less than 135 mEq/L (Normal SodiumValues 135 to 145 mEq/L). Characterized by:

_ Not enough sodium in the ECF (vascular space).

_ Possibly, there is too much water diluting the blood which makes serum sodium go down.

_ Anytime there is a sodium problem there is a fluid problem as well.

Sodium;

•Major extracellular fluid cation

•Maintains tonicity of extracellular fluid

•Regulates acid-base balance by renal reabsorption of sodium ion (base) and excretion of hydrogen ion (acid)

•Facilitates nerve conduction and neuromuscular function

•Facilitates glandular secretion

•Regulates osmotic forces and therefore regulates water balance. Sodium balance is regulated by aldosterone

What causes it and why:

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Signs and symptoms and why:

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Diagnosis:

_ The main diagnostic test for hyponatremia is serum electrolytes (blood work); this is the quickest and simplest way to see what the serum sodium actually is.

• Serum sodium 100 mEq/24 hours

* mEq/L: milliequivalent is one-thousandth of an equivalent—the amount of a substance that will react with a certain number of hydrogen ions. This is measured per liter of fluid.

What can harm the patient?

Seizures and brain damage are the major complications associated with hyponatremia.

Also, consider what caused the hyponatremia when determining what could harm your patient.

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_ Hypernatremia is serum sodium greater than 145 mEq/L.

_ Hypernatremia is similar to dehydration: there is too much sodium and not enough water in the body.

What causes it and why: Anything that causes an increased “water” loss or excessive sodium intake can cause hypernatremia.

[pic]*NPO= (nothing by mouth)

Alterations in sodium balance are used to maintain the plasma volume and tissue perfusion, not the plasma Na+ concentration.

Too much sodium is manifested as edema, and too little sodium results in hypovolemia.

The primary protective mechanism against hypernatremia is the stimulation of thirst, thereby increasing water intake and lowering the plasma Na+ concentration to normal.

• Since aldosterone affects both Na+ and K+ handling, it might be expected that regulation of the excretion of one ion would interfere with that of the other.

Aldosterone secretion may be increased by hyponatremia and reduced by hypernatremia.

Signs and symptoms and why

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*(LOC)=level of consciousness *(DTRs)=Decreased deep tendon reflexes

Diagnosis:

- The quickest way to determine hypernatremia is serum electrolytes (blood work):

• Serum sodium >145 mEq/L

• Urine sodium 145 mEq/L |

| |consciousness |Urine sodium ................
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