Hyponatremia Treatment 

Hyponatremia....the deficit of sodium in the blood.  "How hard could it be to treat?  Just add some sodium in the blood." you may think.  In truth, it is a little more complicated than that.  There are two modes to treating hyponatremia: pharmacologic and fluid/electrolyte balancing by infusing IV solution, such as normal saline. Since hypotonic hyponatremia accounts for most clinical cases of hyponatremia, the first step is to evaluate the degree of hypotonic hyponatremia to determine whether emergency therapy is needed (1).  Treatment is guided by three factors: Patient's volume status, duration and magnitude of the hyponatremia, and degree and severity of clinical symptoms (1).   For asymptomatic patients there are a few treatments depending on the severity of the hypponatremia. For hypovolemic hyponatremia, there are a few options for treatment: administer isotonic saline to patients to replace intravascular volume (1).  Patients who have hyponatremia secondary to diuretics may also need K+ repletion, which is osmotically active just like sodium.  By correcting the volume repletion, the stimulus to ADH secretion is turned off.  A large water diuresis may be caused, which may lead to a much more rapid correction of hyponatremia that may cause other complications, so a hypotonic fluid such as D5 1/2 normal saline may be administered (1).  For hypervolemic hyponatremia, patients are treated with salt and fluid restrictions, loop diuretics, and correction of the underlying condition that may be causing hypervolemic hyponatremia (1).  For euvolemic (normal volume) asymptomatic hyponatremic patients, free water restrictions is the treatment of choice (1).  Below, I have included a chart that helps (and helped me a lot) in visualizing what each type of hyponatremia is and what treatment we should give.  

Treatments for Different Types of Hyponatremia

Works Cited

1.  Simon, E. (2015, March 15). Hyponatremia Treatment & Management. Retrieved May 6, 2015, from http://emedicine.medscape.com/article/242166-treatment