Approach to Hyponatremia:

Be aware that clinical signs and symptoms may not develop until Na <130

• Initial sympoms: headache, nausea and vomiting, disorientation, confusion, agitation, ataxia, arreflexia

Severe symptoms can develop with Na < 120

• Severe symptoms: intractable vomitng, seizures, coma and ultimately brainstem herniation can occur

Stay tuned for next week's post when we review treatment of hyponatremia including the dreaded Osmotic Demyelination Syndrome!

References:

Petrino, Roberta, and Roberta Marino.. "Fluids and Electrolytes." Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8eEds. Judith E. Tintinalli, et al. New York, NY: McGraw-Hill, 2016, pg 95-97.

Mount, David B.. "Fluid and Electrolyte Disturbances." Harrison's Principles of Internal Medicine, 19eEds. Dennis Kasper, et al. New York, NY: McGraw-Hill, 2014, http://accessmedicine.mhmedical.com.ezproxy.rowan.edu/content.aspx?bookid=1130&sectionid=79726591.