General Information

DEFINITION--Above normal sodium level (hypernatremia) or below normal sodium level (hyponatremia) in the blood. Sodium helps regulate the body's water balance, maintains normal heart rhythm, and is responsible for the conduction of nerve impulses and the contraction of muscles.

BODY PARTS INVOLVED--All body cells.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Confusion.
• Restlessness and anxiety.
• Weakness.
• Muscle cramps (usually in the legs).
• Changes in pulse rate and blood pressure.
• Tissue swelling (edema).
• Stupor or coma (if severe imbalance). Sodium imbalance may be part of a disease with other symptoms that predominate, such as fever, vomiting, diarrhea or excessive sweating.

CAUSES

Hyponatremia:

• Prolonged loss of body fluids from vomiting or diarrhea.
• Addison's disease.
• Congestive heart failure.
• Prolonged, excessive drinking of water. (This is usually a psychiatric condition.)
• Some cancers of the adrenal glands.
• Infections with high fever.

Hypernatremia:

• Inability to drink water, as with stroke or gastrointestinal diseases.
• Use of cortisone drugs.
• Excessive intake of salty food or liquid, as in near-drowning in salt water.

RISK INCREASES WITH

• Diabetes mellitus.
• Congestive heart failure.
• Use of diuretics.
• Kidney diseases. Healthy kidneys can usually control sodium levels.

HOW TO PREVENT--Because sodium disturbance is the result of underlying disease, obtain early medical treatment to prevent a sodium imbalance.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood and urine studies of sodium and other electrolytes.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis and treatment.
• Doctor's treatment.
• If a drug is the cause for sodium imbalance (above or below normal), it may be discontinued or dosage lowered.
• For below normal sodium levels, water restriction is usually the therapy. This will increase the sodium levels in the body. It is important that the treatment not overcorrect the sodium levels as that can be dangerous.
• For above normal levels of sodium, administration of fluids (such as dextrose in water) to return sodium levels to normal is the usual therapy.

POSSIBLE COMPLICATIONS--Shock and death.

PROBABLE OUTCOME--Usually can be corrected with intravenous fluids and treatment of the underlying disorder.

How To Treat

GENERAL MEASURES----If you have a disorder or take drugs that affect sodium balance, learn as much as possible about your drugs, your condition and how to prevent a sodium imbalance.

MEDICATION--Your doctor may prescribe:

• Intravenous sodium if sodium levels are low.
• Diuretics to decrease high sodium levels.
• Medications to correct underlying disorders.

ACTIVITY--Bed rest until stable, or underlying condition resolved or controlled. Resume your normal activities after recovery.

DIET--No special diet for low sodium levels. Most persons with high sodium levels benefit from a low-salt diet (see Reduced Sodium Diet in Appendix). Low-salt diets contain enough sodium to prevent hyponatremia. However, sodium levels are not influenced by diet alone.

Call Your Doctor If