Hyponatremia (Low Sodium)

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Hyponatremia

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Hyponatremia
-Possible precipitants include: GI loss vs diuretics vs renal cause vs endocrine cause vs polydipsia vs hyperglycemia vs lab error.
-Will fluid restrict.
-Consider use of vasopressin 2 receptor inhibitors after discussing with nephrology.
-F/u Plasma osmolality (275mOsm/kg to 290mOsm/kg),  urine osmolality, urine sodium concentration, TSH, ACTH, serum urea, LFTs, CT or X-ray chest, CT head.
-Will Administer 3%NaCl; 100 mL IV bolus (repeat up to twice if symptoms persist) for severely symptomatic hyponatremia. 
-No more than 8 mEq/L in any 24hr period to prevent osmotic demyelination syndrome.
-Consulted nephrology for co-management.