저나트륨혈증 초기 진단 평가는 1. 병력 2. 신체진찰 3. 선택적 검사로 이루어져 있습니다.
The initial diagnostic approach to the adult patient with hyponatremia consists of a directed history and physical examination as well as selected laboratory tests. When hyponatremia is first discovered, some elements of the history, key features of the physical exam, and the results of several helpful laboratory tests are usually already available, and these guide the subsequent diagnostic approach.
고혈당이 있다면 hypertonic hyponatremia를 배제하기 위해 포도당 효과로 인한 혈청 나트륨혈증 농도를 교정해야 합니다.
If hyperglycemia is present, the serum sodium concentration should be corrected for the effect of glucose to exclude hypertonic hyponatremia.
Isotonic 또는 hypertonic hyponatremia의 가능한 원인 평가를 위해 다음과 같은 병력 청취, 초기 검사가 필요합니다.
In addition, other patients whose history and initial laboratory studies suggest one of the following should be evaluated for possible isotonic or hypertonic hyponatremia.
· Patients who have had recent surgery utilizing large volumes of electrolyte-poor irrigation fluid (eg, prostate or intrauterine procedures)
· Patients treated with manitol, glycerol, or intravenous immunoglobulin
· Patients with lipemic serum
· Patients with obstructive jaundice
· Patients with a known plasma cell dyscrasia
고혈당이나 위에 언급된 isotonic 또는 hypertonic hyponatremia와 관련된 특징들이 없는 환자들은 hypotonic hyponatremia일 개연성이 있습니다.
Patients who do not have hyperglycemia or one of these other features associated with isotonic or hypertonic hyponatremia are likely to have hypotonic hyponatremia
REF. UpToDate 2019.07.21
