Case Report on Management and outcome of Hyponatremia with SIADH

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Ms. Seema Kolhe, Roshan Umate, Bharat S. Sudame

Abstract

Hyponatremia is the most common electrolyte disorder seen in the hospital. Serious complications of severe symptomatic hyponatremia include cerebral edema, brain herniation, convulsions, obtundation, coma, and respiratory arrest. On the other hand, rapid correction of chronic severe hyponatremia can result in osmotic demyelination syndrome (ODS) and death. The most common cause of hyponatremia in cancer patients is syndrome of inappropriate antidiuretic hormone secretion (SIADH); this oncologic emergency requires immediate treatment. It can lead to increased mortality and morbidity if left untreated. Doctors must be informed and capable of evaluating and determining whether patients are in a fluid and electrolyte crisis. Hyponatremia is defined as an electrolyte abnormality with a sodium level less than 135 meq/L. Nurses should be aware of specific cancers and treatments that put patients at risk for hyponatremia. Present complaints and investigation: Weakness, lethargy, headaches, anorexia, and weight gain are symptoms cerebral edema, brain herniation, seizures, obtundation, coma, and respiratory arrest She exhibited a 96-beat-per-minute tachycardia and excellent peripheral perfusion. With a blood pressure reading of 130/76 mm Hg She had bilateral pain sensitivity and only reacted to pain neurologically. Reactive mydriasis is a type of mydriasis that occurs when the temperature was 38°C, a critical care unit for closer monitoring. the observation. The blood sugar level was 7.4 mmol/L, and the sodium level in the ECG, blood chemistry, and osmolality was 253 mOsm/kg. The salt level in the urine was 134mmol/L, and the osmolality was 404 mOsm/kg. Methamphetamine was detected in the urine. A contrasted CT scan of the brain revealed no abnormalities. Past history: 6 month ago patient admitted MGIMS hospital Sewagram chief complaint Weakness, lethargy, headaches, anorexia, and weight gain then CBC, HB, Sodium level check she diagnosis hyponatremia she  took the treatment for that. The main diagnosis, therapeutic intervention and outcomes: After physical examination and investigation doctor diagnose a case hyponatremia with (SIADH ) Medical therapy for the patient's syndrome of inappropriate antidiuretic hormone included hypertonic 3 percent saline, intravenous thiamine, multivitamin, and folic acid solution. Treatment for a deficiency in dietary solutes. She take treatment of hypovolemia IV blood plasma transfusion. She was took all treatment and outcomes was good. His sign and symptoms  was not  reduced , weakness, lethargy, headaches was slightly reduced after medication he was able to him own activity. No any changes  in therapeutic intervention. Conclusion:  The patient was admitted to the hospital with the following chief complaints The patient was admitted to the hospital with the primary complaint of Following the completion of all investigations, the patient was diagnosed with Hyponatremia. is a prevalent condition that is often misdiagnosed, undervalued, and treated inappropriately.  Now patient required proper medical intervention and needs good nursing care.

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