Possible signs and symptoms include:
- cardiac failrue
- muscle weakness
My personal way of dealing with hyponatraemia is to begin by asking 2 cynical questions:
- is it actually just dilutional? - ?hyperglycaemia
- is it actually just pseudo? - ?high protein ?high triglycerides
Once I've got negatives to my cynicism, I move on to ask:
- are they dehydrated or not?
The divisions from this question onwards are summarised in the diagram below:
If the low sodium is chronic, you treat by:
- treating cause
- giving cautious N.saline if dehydrated
- fluid restricting if not dehydrated.
Occasionally demeclocycline might be needed; this is an antibiotic which has the side effect of inducing nephrogenic diabetes inspidus and hence helps treat SIADH.
Now on to neutrophils...