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Old 03-19-2012
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Question hyponatremia...water restriction or hypertonic saline

A 72-year-old female who lives in a nursing home presents to the emergency room for mental status changes. She was recently diagnosed with lung cancer and has become more confused and developed a mild resting tremor of her hands in the last 24 hours. Vital signs are remarkable for a pulse of 101 beats/min but are otherwise normal. On examination she is oriented to person and place but not month. She does have a mild intention tremor, but her neurologic exam is otherwise normal. Labs show a urinalysis that is negative for leukocyte esterase, white blood cells, and nitrite. Complete blood count is normal. Electrolyte panel is remarkable for sodium of 114 mEq/L. Urine sodium and osmolarity are both found to be elevated. What intervention would constitute the most appropriate treatment for this condition?

A. Desmopressin acetate
B. Hypertonic saline
C. Salt pills
D. Stress dose steroids
E. Water restriction

please give expln.
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Old 03-19-2012
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SIADH: asymptomatic hyponatremia give fluid resriction and if there is no response give demeclocyclin
mild symptomatic hyponatremia normal salin
sever hyponatremia <120 or any neurologic symptome give hypertonic salin 3%
hopefully this help you good luck.
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Old 03-20-2012
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Quote:
Originally Posted by alex85 View Post
SIADH: asymptomatic hyponatremia give fluid resriction and if there is no response give demeclocyclin
mild symptomatic hyponatremia normal salin
sever hyponatremia <120 or any neurologic symptome give hypertonic salin 3%
hopefully this help you good luck.
so, whats your ans?
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Old 03-20-2012
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E. Water restriction - start with this and then move forward from here.
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Old 03-20-2012
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hypertonic saline, bcoz this pt has neurological changes
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Quote:
Originally Posted by tyagee View Post
so, whats your ans?
really!!!!!!! it's hypertonic salin....
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Old 03-20-2012
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e. water restriction to800ml/dl can incerse na. hypertonic saline used in sever confusion,convlusion and coma.
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B. Hypertonic saline...since symptomatic....if mild then i think e
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Old 03-21-2012
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Quote:
Originally Posted by um aala View Post
e. water restriction to800ml/dl can incerse na. hypertonic saline used in sever confusion,convlusion and coma.
ya ans is water restriction and ur reasoning seems perfect...
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Endocrinology-, Internal-Medicine-, Nephrology-, Step-2-Questions

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