18 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
and Workup Step ... Repeat the sodium ... EUVOLEMIC • SIADH ... HYPERVOLEMIC • CHF ... #Algorithm #Nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Diagnosis Algorithm ... treat underlying cause ... (CHF, cirrhosis ... , SSRIs) - SIADH ... diagnosis #nephrology #sodium
Hyponatremia Treatment Algorithm

CHF, Cirrhosis - Fluid restriction
SIADH - Fluid restriction
 - Consider salt tablets if etiology
Hyponatremia Treatment ... Algorithm CHF ... Fluid restriction SIADH ... #Treatment #Algorithm ... #Management
Hyponatremia - Diagnostic Evaluation Algorithm

Step 1: Consider whether Posm may actually be normal or elevated
Step 2:
Evaluation Algorithm ... Check Uosm and/or Urine ... tests Step 5: If SIADH ... considered likely, the cause ... #Diagnosis #Workup
Management of SIADH
Treat underlying cause:
 • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
Management of SIADH ... promoting passive sodium ... Saline: • If Urine ... #Management #hyponatremia ... #nephrology #treatment
Hyponatremia - Diagnosis and Treatment
Hyponatremia is usually caused by the inability to excrete water normally.
3 questions to work ... Measure urine osmolality ... include vaptans (HF ... #management #nephrology ... #sodium
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
time you have a case ... normal volume-based algorithm ... Urine Na+K / serum ... restriction alone in SIADH ... , Renal Sodium loss
SIADH Treatment Options
1. Treat underlying cause of SIADH: Pain, Primary lung pathology, Post-operative phenomenon, Medications, Basically
SIADH Treatment ... Treat underlying cause ... promoting passive sodium ... 0.9% NS • If Urine ... #Management #hyponatremia
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Algorithm Isotonic ... • Euvolemia: SIADH ... Alcohol MH/CCF ... #diagnosis #causes ... #nephrology #sodium
Hypertonic Saline for Treatment of Hyponatremic Encephalopathy
1) 100 ml bolus of 3% NaCl over 10 min.
Hypertonic Saline for Treatment ... of Hyponatremic ... L. 5) Monitor urine ... #management #protocol ... #hyponatremia