Nursing Diagnosis/Intervention for Hyponatremia

There are many nursing diagnosis for hyponatremia.  With two types of hyponatremia (depletional and dilutional), there are different interventions and nursing diagnosis for the sodium deficit.  In this blog, I will give some associated nursing diagnosis for hyponatremia and will analyze the "deficient fluid volume r/t diuresis" nursing diagnosis for it's interventions as well. 

1.Deficient fluid volume related to fluid loss, leading to hyponatremia. (Actual for depletional hyponatremia)

- This is due to the patient losing too much sodium through urination.  The sodium is excreted through the urine, diarrhea, sweat, etc.  This will cause depletional hyponatremia.  This is very apparent, especially in patients in the hospital with Clostridium dificile (C. Diff) infections, leading to diarrhea and excess fluid/sodium excretion.  This is also very common in athletes who lose too much water and salt through sweat, which can lead to hyponatremia. 

Interventions:
-Administer IV isotonic solution as ordered
-Restrict free water intake. 

Monitor for(2): 
-Vital signs hourly and I/O
-Monitor serum sodium levels. 
-Fluid Monitoring.  

2. Excess fluid volume related to hyponatremia.  

-This would be dilutional hyponatremia, where the fluid volume in the body is so high that it will dilute the sodium in the body, making the concentration lower, thus affecting bodily functions such as nerve transmission and causing confusion/muscle cramps (3).  The symptoms will be the same as well for depletional hyponatremia.  

3. Disturbed energy field related to increased intercranial pressure from hyponatremia.

-This mostly relates to dilutional hyponatremia, where the fluid volume excess shows up in the brain, along with an increased intercranial pressure(1).  The increased intercranial pressure may cause many problems with mental status and may be very serious. 

4. Acute confusion related to hyponatremia. 

-This could be related to one of two things.  One is that the lowered sodium levels in the blood affects the nerve transmissions in the brain, causing confusion. Another factor that could play a large part in confusion is the increased intercranial pressure related to hyponatremia as well, which "cramps" the brain, causing mental function to decline.  With the decline of mental function in certain areas of the brain, it can cause confusion of the individual.  

5. Activity intolerance related to hyponatremia as evidenced by muscle spasms/weakness. 

-With less sodium in the muscle, the nerves will not function as effectively, which can cause muscle spasms or weakness.  This may cause much discomfort and may put the patient at a risk for falls.  This is especially dangerous in geriatric patients, as falls are much more dangerous to that particular population.  

Works Cited:

1. McGill University. (2013, August 20). A new role for sodium in the brain.ScienceDaily. Retrieved May 18, 2015 from www.sciencedaily.com/releases/2013/08/130820113931.htm

2.Nursing-Nurse.Com. (2007). Retrieved May 18, 2015, from http://www.nursing-nurse.com/medical-and-nursing-management-of-sodium-deficit-hyponatremia-serum-sodium-466/

3. Antipuesto, J. (2010, December 15). Fluid and Electrolyte Imbalance: Hyponatremia | Nursing Crib. Retrieved May 18, 2015, from http://nursingcrib.com/nursing-notes-reviewer/fundamentals-of-nursing/fluid-and-electrolyte-imbalance-hyponatremia/