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. |
