Electrolyte disturbances ((series))

ELECTROLYTE DISTURBANCES ((SERIES)) :radioactive::radioactive:

:sparkling_heart::sparkling_heart:HYPERNATRAEMIA :sparkling_heart::sparkling_heart:

:recycle:Na more than 145 mmol/l.

:recycle:Severe symptoms mainly develop when Na > 160mmol/l.

:recycle:more severe with acute hypernatraemia.

:recycle:Chronic (> 5 days) well tolerated due to brain compensation.

:recycle:Hypernatremia may lead to underestimation of degree of
dehydration​:point_right::point_right: Weight loss is more reliable.

:recycle:The child may appear sicker than expected for the clinical
signs of dehydration that are present.

:recycle:Shock occurs late because I.V volume is relatively preserved.

Look for signs of intracellular dehydration and neurological dysfunction:
:arrow_forward:Lethargy or Irritability.
:arrow_forward:Skin feels “doughy”.
:arrow_forward:Ataxia, tremor, Hyperreflexia.
:arrow_forward:Seizures, reduced GCS.

:sparkling_heart::sparkling_heart:HYPONATRAEMIA :sparkling_heart::sparkling_heart:

:recycle:Hyponatraemia is defined as serum sodium < 135mmol/L.

:recycle:Most children with Na > 125mmol/L are asymptomatic.

:recycle:Hyponatraemia and rapid fluid shifts lead to cerebral oedema.

:recycle:If Na < 125mmol/L or if serum sodium has fallen rapidly vague
symptoms such as nausea and malaise are more likely and
may progress.

:recycle:If Na < 120mmol/L: headache, lethargy, obtundation & seizures
may occur.

:recycle:Chronic hyponatraemia (developing > 24 hours)

:recycle:Ch hyponatraemia​:point_right: more subtle features( restlessness,
weakness, fatigue or irritability)

:recycle:Rapid correction of hyponatraemia can result in osmotic
demyelination syndrome which manifests as😨((irreversible))
neurologic features (dysarthria, confusion, obtundation and
coma) which often present days after sodium correction.

:recycle:Hyponatraemic seizures may be refractory to anticonvulsants and sodium correction should not be delayed.