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Hyponatremic Dehydration 1


Hyponatremic Dehydration

Elisabeth Fandrich

Montana Tech Nursing Department

NURS 1566 Core Concepts of Adult Nursing

March 3, 2008

Noel Mathis RN, BSN, MSN

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Hyponatremic Dehydration

Dehydration is a negative fluid balance in the body. Often dehydration is categorized

based on sodium levels. If water and sodium are lost relatively equally, it is called

isonatremic dehydration. If more water than sodium is lost, it is called hypernatremic

dehydration and if more sodium than water is lost, it is hyponatremic dehydration.

Hypernatremic and hyponatremic dehydration only make up about 5% to 10% of all

dehydration cases.

Hyponatremic dehydration causes intravascular fluid to move into the extravascular

spaces because of low serum sodium.

The underlying reasons for hyponatremic dehydration are often not known, as was the

case with my assigned patient, W,T,3512 . Some common causes of hyponatremic

dehydration are less than adequate fluid intake, excessive urine output, diarrhea,

vomiting, diuretics, Addison’s Disease, and SIADH (Syndrome of Inappropriate

Antidiuretic Hormone).

Patients are usually asymptomatic until their serum sodium falls below 125 mmol/L or if

sodium levels decline rapidly. As of March 4, 2008, W,T,3512 had a serum sodium level

of 127 mmol/L and appeared asymptomatic upon assessment. At that point (125

mmol/L), symptoms that will develop are nausea, lethargy, confusion and headache. In

severely hyponatremic patients, seizures, coma, brain damage and death may occur.

Diagnoses is based on history and physical as well as labs, most notably, serum sodium.

To treat hyponatremic dehydration, the underlying cause (if known) must be treated. 5%

dextrose in 0.9% NaCl is used as a replacement fluid. The amount of the sodium in the
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replacement fluid is adjusted in order to allow sodium levels to rise slowly. Rapid

increase of sodium can cause central pontine myelinolysis (destruction of the myelin

sheaths of nerves in the pons resulting in nerve damage).

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Ellsbury, MD, FAAP, Dan (March 30, 2006). Dehydration. eMedicine from webMD,

Retrieved March 4, 2008, from

General OneFile (September 21, 2007). Clinical Review: Hyponatremia. GP: 29Gale.

Montana Tech Library. Retrieved March 4, 2008, from