Question

ACTIVE LEARNING TEMPLATE Basic Concept STUDENT NAME CONCEPT Perfusion REVIEW MOOULE CHAPTER Nursing Interventions Related Content Underlying Principles WHOYHEN7 WHY HOW EG DELEGATION LEVELS OF PREVENTION ADVANCE DIRECTIVES

In the related content section you want to talk about what the concept is related to. For example, fluid is related to water, hydration, sodium balance, volume.

In the underlying principles what is important to know about the concept you’ve chosen. For example, fluid is regulated by sodium.

And lastly nursing intervention. You want to reinforce the information collected in the related to section and the underlying principle.

Based on the fact fluid is related to sodium balance and that balance regulates the amount of water in the body, an appropriate nursing intervention is: assess sodium level.

Answer 1

Water is essential for life, and maintaining hydration is important for physical and mental performance. The human body is largely made of water. Body water content declines with age, from about 75% in babies to 60% in adults. Although we can live for up to 50 days without food, without water we will survive only a few days, even in a cool climate. People generally drink enough water, but for specific population groups, like the elderly, or while exercising, fluid intake might become critical.

Related content:

HYPONATREMIA

A serum sodium level below 135 mEq/L is considered hyponatremia. This condition can be due to low levels of sodium or to excess water in relation to the amount of sodium, sometimes referred to as dilutional hyponatremia. Some common causes of hyponatremia include profuse diaphoresis, draining wounds, excessive diarrhoea or vomiting, trauma with significant blood loss, low sodium intake, hormonal changes associated with Addison disease or hypothyroidism, and overuse of thiazide diuretics. Low sodium levels may be seen in patients with aldosterone deficiency due to adrenal insufficiency and in patients diagnosed with the syndrome of inappropriate secretion of antidiuretic hormone. Hyponatremia is also a common electrolyte imbalance in postoperative patients.

Underlying principles:

Sodium is actively absorbed by the intestines and excreted by the kidneys. The body possesses an intricate system of safeguards and feedback mechanisms to monitor and maintain the sodium level in the extracellular fluid. When sodium levels begin to rise, the body makes adjustments by stimulating a thirst mechanism, which encourages the person to drink additional water.

Sodium levels are influenced by antidiuretic hormone (ADH) and aldosterone through their sodium and water conservation and excretion feedback mechanisms. Increased secretion of ADH causes more water to be reabsorbed in the kidneys; decreased ADH secretion allows more water to be excreted.

Aldosterone is a mineralocorticoid produced in the adrenal cortex. High aldosterone levels promote the reabsorption of sodium, along with water and chloride, in the kidneys' distal tubules. Because the body is so adept at protecting its sodium, people don't need to ingest large quantities of sodium.

Sodium functions to maintain acid-base balance by readily combining with chloride and bicarbonate ions. This facilitates the maintenance of balance between cations and anions to help prevent pH imbalances.

Nursing Interventions:

Assessment

A drop in sodium level causes cellular oedema, which affects the central nervous system (CNS), leading to CNS depression and cerebral oedema. Monitor patients for signs and symptoms of CNS depression (mental status changes, headache, personality changes, and irritability). Gastrointestinal (GI) symptoms of hyponatremia include nausea, vomiting, abdominal discomfort, and diarrhoea. Severe hyponatremia (115 mEq/L or less) causes muscle twitching and tremors, focal weakness, seizures, signs of increasing intracranial pressure, and coma.

Treatment :

The treatment goal is to determine and treat the underlying cause of hyponatremia and replace the lost sodium. Because sodium is plentiful in a normal diet, patients who can eat and drink can easily replace low levels. But those who can't take sodium orally may require I.V. administration of lactated Ringer's solution or 0.9% sodium chloride solution. The patient may also need to restrict water intake.

Tolvaptan is an oral medication used to treat clinically significant hypervolemic and euvolemic hyponatremia (serum sodium less than 125 mEq/L or less marked hyponatremia that causes symptoms and hasn't responded to correction with fluid restriction).