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Definition:

Sodium is the most abundant cation and the chief base of the blood.

Its primary functions in the body are to maintain osmotic pressure and acid-

base balance chemically and to transmit nerve impulses.

Mechanisms for maintaining a constant sodium level in the plasma and

extracellular fluid include renal blood flow, carbonic anhydrase enzyme activity,

aldosterone, and action of other steroids.

Determinations of serum sodiumbalance detect changes in

waterbalance rather than sodium balance.

Sodium levels are used to determine electrolytes, acid-base balance,

water balance, water intoxication and dehydration.

Normal Values:

Infants !"" # !$% m&'()

*hildren +! # ! years old !" # !$ m&'()

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 /dults !" # !$ m&'()

Procedure:

0his is done by obtaining m) of venous blood serum sample.

1eparinized blood can be used.

 /void hemolysis.

Clinical Implications:

Increased sodium ( hypernatremia

!. dehydration and insufficient water inta2e

%. *onn3s syndrome

". primary aldosteronism

$. coma

. *ushing3s disease

. diabetes insipidus

4. tracheobronchitis

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Decreased sodium ( hyponatremia

!. severe burns

%. congestive heart failure

". excessive fluid loss such as severe diarrhea, vomiting

$. excessive I5 induction of nonelectrolyte fluids such as glucose

. /ddison3s disease

. severe nephritis

4. pyloric obstruction

6. malabsorption syndrome

7. diabetic acidosis

!8.drugs such as diuretics

!!. edema

!%.large amounts of water per orem

!".hypothyroidism

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!$.excessive /D1 production

Interfering Factors:

 /nabolic steroids, corticosteroids, calcium, fluorides, and iron can increase

sodium levels.

1eparin, laxatives, sulfates and diuretics can cause decreases in sodium

levels.

1igh triglycerides or low protein can cause artificially low sodium values.

Decreased serum sodium:

!. /ssess for signs and symptoms of hyponatremia. +apprehension, anxiety,

muscular, twitching, muscular wea2ness, headaches, tachycardia and

hypotension

%. 9e 2nowledgeable that hyponatremia after surgery is the result of SI/D1.

0here is an increased reabsorption from the 2idney and sodium dilution

between one to two days before the surgery.

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". 0a2e vital signs to determine cardiac status during hyponatremia.

Increased serum sodium:

!. *hec2 for signs and symptoms of hypernatremia. +restlessness, thirst, flushed

s2in, stic2y mucous membrane, a rough dry tongue and tachycardia

%. :eep an accurate record of input and output of fluids.

". ;bserve for signs of edema and overhydration resulting from an elevated

serum sodium level.