In an effort to allay anxiety (and as a fun illustrative distraction) I am attempting to learn one thing from Harrison's Manual of Medicine a day and illustrate it concisely into a pocket manual, a "Natter's Harrison's" if you will. I hope the tiny notebook will sit in my white coat and offer me some reassurance as I build my doctor chops next year. Please feel free to comment w any helpful tips on the topic or edits/corrections you see fit. All advice is welcome and appreciated
Hyponatremia is largely an issue with water and antidiuretic hormone. 3 flavors exist: low water status (2/2 hypoaldosterpnism, diuretic use, others) which is treated with addressing underlying problem and normal saline. Normal water status, usually from SIADH which is treated by addressing primary cause of high ADH, water restriction, and ADH antagonists, loop diuretics. Or lastly, those drowning in fluid (CHF, cirrhosis etc) here we treat underlying cause, so diuretics or large volume tap.
If sodium suddenly drops, drops below 120, or pt is severely symptomatic- can give hypertonic fluid but do it SLOWLY! •
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