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Nursing Interventions for Hyponatremia - Nursing Care Plan

Nursing Interventions for Hyponatremia, Nursing Care Plan, NANDA,


Nursing Diagnosis and Nursing Interventions of Hyponatremia

What is Hyponatremia?

Hyponatremia is a condition where the sodium level in the blood is less than 135 milliequivalents per liter (135 mEq/L).

It refers to a low level of sodium in the blood and due to this condition too much water holds onto the body.

Signs and Symptoms of Hyponatremia.

• Nausea and vomiting
• Loss of energy
• Fatigue and drowsiness
• Headache
• confusion
• Irritability
• Muscle spasms and weakness
Seizures
• coma

Causes of Hyponatremia

Medications - There are some medications which affect the fluid balance in the body which leads to a decreased level of sodium in the body. Such medications are diuretics, pain killers and antidepressants that affect the normal hormonal and kidney processes.
Dysfunctions of heart, kidney and liver - Due to the dysfunctions of the heart, kidney and liver the body fluids accumulate in the body which dilutes the sodium in the body and decreases the sodium level.
Syndrome of inappropriate antidiuretic hormone (SIADH) - In this disorder, the body secretes high amounts of antidiuretic hormone and due to this water remains in the body instead of excreting as urine.
Severe dehydration - Severe vomiting, diarrhoea and other causes lead to severe dehydration and these causes lose of electrolytes from the body.
Excessive fluid intake - Excessive water or fluid intake dilute the sodium in the body and also leads to excessive urination which decreases the sodium level in the body.
Changes in hormone production - Certain conditions alternate the normal hormone production from the adrenal gland, which affects sodium, potassium and water balance.

Risk Factors of Hyponatremia -

There are some risk factors which increase the chances of hyponatremia -

Age - Older adults have more chances of developing hyponatremia.
Drugs - Certain medications increase the risks of hyponatremia such as antidepressants, diuretics and pain killers medications.
Disease conditions - There are some medical conditions which increase the risk of hyponatremia such as kidney disease, SIADH, heart failure etc.
Excessive fluid intake during physical activities - Excessive fluid intake during physical activities increases the risk of hyponatremia as it dilutes the sodium level and increases urination.

Complications of Hyponatremia -

In hyponatremia, the sodium level decreases rapidly which results in swelling in the brain, coma and death.

Diagnosis of Hyponatremia -

History collections
Physical examinations
Urine analysis - For measuring sodium level in urine and osmolarity.
Blood tests - For measuring the serum sodium level and ADH level in the body.

Treatment of Hyponatremia -

Restriction in fluid intake - Fluid restrictions prevent sodium dilution as fluid volume decreases in the body. For mild hyponatremia clients, fluid restriction treats the condition and maintains a normal sodium level.
Administration of IV fluids - Slow administration of sodium solutions in the intravenous increases the sodium level in the blood. However, rapid administration can lead to complications and side effects. Follow the physician's advice.
Medications - There are some medications, your physician may stop if they induce hyponatremia. Also, your physician may advise some medications to treat hyponatremia.

Nursing Diagnosis and Nursing Interventions for Hyponatremia - Nursing Care Plan


Nursing Diagnosis for Hyponatremia - 1

• Electrolyte imbalance related to diarrhea, vomiting, profuse sweating and renal disease.

Expected Outcome -

The client will be able to maintain normal fluid and electrolyte balance.

Hyponatremia Nursing Interventions

Rationale

Monitor the client's vital signs especially respiratory rate and depth. Monitoring vital signs is important to understand the client's current condition. Also, a patient may experience slow and shallow respiration.
Collect urine and blood sample from the client. Blood test and urine analysis help to measure the sodium and osmolarity levels in the body. ADH test measures ADH level.
Restrict the fluid intake of the client as per the physician's advice. Fluid restriction prevents sodium dilution and frequent urination which helps to maintain sodium balance.
Monitor strict intake and output of the client. Continuous intake output monitoring helps to follow the fluid restriction advice strictly.
Administer sodium solution and medications as per doctor's order. It helps to increase the sodium level and also maintain normal fluid balance.

Nursing Diagnosis for Hyponatremia - 2

• Imbalanced nutrition less than body requirement related to vomiting, diarrhea, loss of appetite and weakness.

Expected Outcome -

The client will be able to maintain a normal body weight and healthy eating habits.

Hyponatremia Nursing Interventions

Rationale

Assess the client's current health condition and eating habits. It helps to understand the current nutritional status of the patient such as weight, BMI and eating habits.
Maintain a weight monitoring chart and record the food and fluid intake daily. To monitor the patient's eating habits, nutritional intake and weight progress.
Provide a small amount and frequent diet to the patient considering nutritional value. To increase calorie intake and decrease the chances of nausea and vomiting after having food.
Refer to the dietician. To provide a specialized and appropriate diet for the hyponatremia patient.

Nursing Diagnosis for Hyponatremia - 3

• Knowledge deficit related to diagnosis of hyponatremia as evidenced by verbalization of the patient.

Expected Outcome -

The patient will be able to gain enough knowledge regarding hyponatremia and its management after the health teaching discussion.


Hyponatremia Nursing Interventions Rationale
Assess the client's current condition regarding emotional status, willingness to learn and learning barriers. To understand the patient's mental status, and knowledge about hyponatremia and also to overcome the barriers to learning.
Explain hyponatremia and its causes, signs, symptoms, diagnosis and management. Explain in simple terms instead of using medical terminology to the patient. To provide information about hyponatremia and how it affects the body in simple terms.
Teach the client about normal sodium levels in the body. Provide proper information about lifestyle and diet modification. To educate the client on normal levels of sodium and its effects on the body and follow-ups.
Educate the caregiver about how to monitor the intake and output of the patient strictly. To monitor the patient's intake output chart strictly.