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Hyponatremia or hyponatraemia is a low concentration of sodium in the blood. [4] It is generally defined as a sodium concentration of less than 135 mmol/L (135 mEq/L), with severe hyponatremia being below 120 mEq/L. [3] [8] Symptoms can be absent, mild or severe.
If the levels of an electrolyte are too low, a common response to electrolyte imbalance may be to prescribe supplementation. However, if the electrolyte involved is sodium, the issue is often water excess rather than sodium deficiency. Supplementation for these people may correct the electrolyte imbalance but at the expense of volume overload.
Hypoaldosteronism causes low sodium (hyponatremia), high potassium (hyperkalemia), and metabolic acidosis, a condition in which the body produces excess acid.These conditions are responsible for the symptoms of hypoaldosteronism, which include muscle weakness, nausea, palpitations, irregular heartbeat, and abnormal blood pressure.
Hypotension and hypovolemic shock are the main symptoms of an adrenal crisis. Other symptoms include weakness, anorexia, nausea, vomiting, fever, fatigue, abnormal electrolytes, confusion, and coma. Laboratory testing may detect low sodium, high potassium, high lymphocyte count, high eosinophils, low blood sugar, and rarely high calcium. The ...
Aldosterone insufficiency in salt-wasting CAH results in significant loss of sodium in the urine. Urinary sodium concentrations may exceed 50 mEq/L. Due to the loss of salt at that rate, the infant is unable to maintain proper blood volume and begins to suffer from dehydration due to hyponatremia by the end of the first week of life.
Moderate or severe hyponatremia, or hyponatremia with severe symptoms is treated by raising the serum sodium level by 1–2 mmol per liter per hour for the first few hours with a goal of raising levels less than 8–10 mmol per liter in the first 24 hours and 18 mmol per liter in the first 48 hours. [2]
Early symptoms of hypovolemia include headache, fatigue, weakness, thirst, and dizziness. The more severe signs and symptoms are often associated with hypovolemic shock. These include oliguria , cyanosis , abdominal and chest pain, hypotension , tachycardia , cold hands and feet, and progressively altering mental status.
Sodium is also important in regulating the amount of water that passes through the blood–brain barrier. Decreased sodium blood levels result in increased permeability of water across the blood–brain barrier. [8] This increased influx of water causes brain swelling which leads to severe neurological symptoms. [8]