Question: How To Manage An Elderly Patient With Hyponatremia?

Question: How To Manage An Elderly Patient With Hyponatremia?

Treatment includes discontinuation of offending drugs and treating any underlying conditions that might be contributing to hyponatremia. Free water restriction is helpful when the urine osmolality is not very high. Loop diuretics and salt tablets may be helpful if fluid restriction does not increase the serum sodium.

What is the management of hyponatremia?

In general, hyponatremia is treated with fluid restriction (in the setting of euvolemia), isotonic saline (in hypovolemia), and diuresis (in hypervolemia). A combination of these therapies may be needed based on the presentation. Hypertonic saline is used to treat severe symptomatic hyponatremia.

What do you do if a patient has low sodium?

Treatment for low blood sodium

  1. cutting back on fluid intake.
  2. adjusting the dosage of diuretics.
  3. taking medications for symptoms such as headaches, nausea, and seizures.
  4. treating underlying conditions.
  5. infusing an intravenous (IV) sodium solution.

How do elderly increase sodium levels?

How to Increase Sodium Levels in Elderly People

  1. Adjust or change medications.
  2. Cut back on water and fluid consumption.
  3. Seek treatment for underlying conditions or diseases.
  4. Eat foods that are high in sodium.
  5. Increase dietary protein to aid in water excretion.
  6. Infusing an intravenous sodium solution.

Do you give normal saline for hyponatremia?

Our review did not reveal any head-to-head comparison trials of different methods or types of intravenous fluids for the treatment of hypovolemic hyponatremia. In practice, infusion with normal saline (9% sodium) is recommended to restore ECF volume by replacing both salt and free water.

What are the warning signs of hyponatremia?

Hyponatremia signs and symptoms may include:

  • Nausea and vomiting.
  • Headache.
  • Confusion.
  • Loss of energy, drowsiness and fatigue.
  • Restlessness and irritability.
  • Muscle weakness, spasms or cramps.
  • Seizures.
  • Coma.
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What is the best way to raise sodium levels?

Intravenous (IV) fluids with a high-concentration of sodium, and/or diuretics to raise your blood sodium levels. Loop Diuretics – also known as “water pills” as they work to raise blood sodium levels, by making you urinate out extra fluid.

Will eating salt help hyponatremia?

In elderly patients with a diet poor in protein and sodium, hyponatremia may be worsened by their low solute intake. The kidney’s need to excrete solutes aids in water excretion. An increase in dietary protein and salt can help improve water excretion.

Can an elderly person recover from low sodium?

Although there is no concrete evidence that the restoration of hyponatremia is associated with improved outcome, it is prudent to correct low sodium concentration even in “asymptomatic elderly individuals” because it is related to increased mortality and morbidity (eg, gait disturbances, falls, cognition impairment).

Which organ is most affected by hyponatremia?

Hyponatremia occurs when your blood sodium level goes below 135 mEq/L. When the sodium level in your blood is too low, extra water goes into your cells and makes them swell. This swelling can be dangerous especially in the brain, since the brain cannot expand past the skull.

How long does it take to recover from hyponatremia?

Generally, low sodium is asymptomatic (does not produce symptoms), when it is mild or related to your diet. It can take weeks or months for you to experience the effects of low salt in your diet—and these effects can be corrected by just one day of normal salt intake.

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What IV solution is given for hyponatremia?

For serious symptomatic hyponatremia, the first line of treatment is prompt intravenous infusion of hypertonic saline, with a target increase of 6 mmol/L over 24 hours (not exceeding 12 mmol/L) and an additional 8 mmol/L during every 24 hours thereafter until the patient’s serum sodium concentration reaches 130 mmol/L.

How do you correct hyponatremia?

Formula for Sodium Correction

  1. Fluid rate (mL / hour) = [(1000) * (rate of sodium correction in mmol / L / hr)] / (change in serum sodium)
  2. Change in serum sodium = (preferred fluid selected sodium concentration – serum sodium concentration) / (total body water + 1)

What IV solution do you give for Hypernatremia?

Patients should be given intravenous 5% dextrose for acute hypernatremia or half-normal saline (0.45% sodium chloride) for chronic hypernatremia if unable to tolerate oral water.

Alice Sparrow

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