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HYPONATREMIA AND
HYPER NATREMIA
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Hyponatremia low sodium level : cause

seizures, headache, tachycardia,
hypotension, cramps and muscle
twitching, irritability, and coma
Hypernatremia high sodium level :
usually indicates a water deficit in the
ECF : symptoms thirst, tachycardia, dry
sticky tongue, disorientation,
hallucination, lethargy to coma, seizures,
hypertension, agitation, low fever
 Hyponatremia
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Most common electrolyte disorders

Neonates and infants are most likely
Sodium level < 135 meq/l
Divided into:
Hypotonic hyponatremia
Non hypotonic hyponatremia
Hypertonic hyponatremia
Isotonic hyponatremia
pseudohyponatremia
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 Treatment
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 Normal value of electrolyte,
oncotic/smotic pressure & plasma pH
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Na+ = 135 150 mEq/L

K+ = 3.5 mEq/L
Cl- = 100 mEq/L
Ca++ = 10 mEq/L
HCO3 = 20 25 mEq/L
Osm = 290 mOsm/kg air
Tek.onk = 17 19 mmHg
Anion Gap = 8 16 mEq/L
pH = 7.35 7.45
pCO 2 = 27 40 mmHg
H2CO3 (mM/L)= pCO 2 x 0.03
 Hypernatremia
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Sodium level > 145 meq/L

Hypertonicity plasma osmolality > 300
mOsm/kg
Indicates deficit of TBW relative to total
body solute
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 Treatment
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Increased plasma osmolality

calculated TBW
TBW (L) = normal TBW (L) x 140
(Na)
Hypernatremia with increased solute
Diuretics and administration of water or 5%
dekstrose in water