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Hyponatraemia

Prevalence
Causes
Clinical features
Investigations
Therapy
Prognosis
Clinical features

Ask about
  • recent illness
  • diarrhoea and vomiting c  
  • sweating c  
  • fluid intake d

  • current medical problems
    • heart failure c  
    • renal disease c  
    • liver failure and ascites c  
    • diabetes mellitus c  
    • any psychiatric problems c  

  • current medication (particularly diuretics, NSAIDs, antibiotics) c  
Patients may have nausea, cramps, confusions, or seizures. However unless the serum sodium is falling rapidly, levels in the range 125-135 mmol/l are usually asymptomatic d

Look for evidence of oedema or dehydration c 

  • When assessing for dehydration, look for a  
    • sunken eyes
    • dry axillae
    • dry nose or mouth mucous membranes
    • longitudinal furrows on the tongue

Expiry date: September 2005
Levels of Evidence used in grading these guides

Authors   T   Ringrose , CM   Ball
Reviewer   J V   Bonventre
CAT Writers   T   Ringrose , CM   Ball