Workup and treatment of hyponatremia, hypernatremia, hypo and hyperkalemia, calcium, magnesium and phosphate disorders, with ECG findings and correction rate limits.
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- What serum sodium level defines hyponatremia?
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Less than 135 mEq/L- What is the first lab test to order when working up hyponatremia?
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Serum osmolality- What common metabolic condition causes hypertonic (translocational) hyponatremia?
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Hyperglycemia- By how much does serum sodium fall for every 100 mg/dL rise in glucose above normal?
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About 1.6 mEq/L- What two conditions cause pseudohyponatremia with a normal measured serum osmolality?
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Severe hyperlipidemia and hyperproteinemia- What is a common cause of hypophosphatemia in hospitalized malnourished patients?
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Refeeding syndrome- In SIADH, how is urine osmolality typically affected despite low serum osmolality?
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Urine osmolality is inappropriately high, usually over 100 mOsm/kg- What is the most common cause of euvolemic hyponatremia?
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SIADH, syndrome of inappropriate antidiuretic hormone secretion- What is the maximum recommended rate of sodium correction for chronic hyponatremia?
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6 to 8 mEq/L per 24 hours- What neurologic complication can result from correcting hyponatremia too quickly?
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Osmotic demyelination syndrome (central pontine myelinolysis)- What is the treatment for severe, symptomatic (seizing) hyponatremia?
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Hypertonic 3% saline- What is the treatment for hypovolemic hyponatremia?
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Isotonic 0.9% saline- What is the first-line treatment for SIADH-related hyponatremia?
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Fluid restriction- What three conditions commonly cause hypervolemic hyponatremia?
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Congestive heart failure, cirrhosis, and nephrotic syndrome- What serum sodium level defines hypernatremia?
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Greater than 145 mEq/L
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