Question

Adam requires treatment for his hyponatremia (Na+ 129 mEq/L; normal: 135 - 145 mEq/liter). The medical team asks for possible means of correcting his sodium through nutritional modifications of his diet.
Questions
1. What are the possible causes of Adam’s hyponatremia?
2. What labs might help you determine its cause?
3. How would you recommend his hyponatremia be treated?
4. Explain your rationale.

Answer 1

ANSWER

1. Possible causes of Adam's hyponatremia.

             * Excessive water intake or water intoxication.

             * SIADH (Syndrome of inappropriate ADH secretion).

             * Congestive heart failure result in accumulation of water

                which dilute sodium in the body.

             * Vomiting.

             * Diarrhea.

             *Use of diuretics result in loss of sodium along with water.

2. Lab tests used to detect cause of hyponatremia.

                 * Serum electrolytes,creatinine,BUN and glucose level.

                 * Urine sodium level.

                 * Serum osmolarity.

               * Urine osmolarity.

                 * ACTH (Adrenocorticotropic hormone) test.

                 * TSH (Thyroid stimulating hormone) test.

3.Treatment of hyponatremia.

                   * Maintain intake and output chart to monitor fluid and electrolyte loss

                      and gains.

                  * Increase intake of sodium rich foods (eg; soups,salad,sea foods,vegetables)

                  * Avoid excess intake of water.

                  * Treatment of underlying causes like diarrhea,vomiting

                     adrenal insufficiency,kidney diseases etc by drug therapy.

                  *Encourage intake of fluid with sodium content.

4. Rationale for treatment plan of this patient with hyponatremia.

                 * Keeping intake and output chart help to analyse fluid balance and

                    give fluids based on sodium level of the patient.

                 * Intake of sodium rich foods useful to regain normal sodium level in the

                    body.

                 * Restricted intake of water avoid chances water intoxication which leads to

                    low sodium level.

                 * Proper treatment of underlying conditions(adrenal,thyroid,heart,kidney problems

                   diarrhea etc) is necessary to maintain normal sodium level.

                 * Fluids with high sodium content increase blood sodium level.