Medliorate

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Approach to Hyponatremia

Posted by medliorator on August 24, 2009

The first question to ask yourself is: Is this a true hyponatremia? …is there truly an imbalance between the ratio of sodium to free water

To calculate what the true sodium level would be in the face of hyperglycemia, take the current level, and add 1.6 times the glucose level minus 100 divided by a hundred.

next consider volume status.  If the patient is dehydrated, then the low sodium is likely due to the compensatory response of ADH, and the treatment is to gently rehydrate the patient using normal saline. However, if the patient is volume overloaded and edematous, think about causes such as cirrhosis, renal failure, or congestive heart failure and treat those as needed. If the patient has normal volume status, they might have syndrome of inappropriate antidiuretic hormone (SIADH) or something more esoteric

How To Work Up Hyponatremia [Scrub Notes]

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