Hyponatraemia
Disclaimer
These guidelines have been adopted to guide clinical decision making for the medical, nursing and allied health staff of Perth Children’s Hospital. They are not strict protocols, and they do not replace the judgement of a senior clinician. Clinical common-sense should be applied at all times. These clinical guidelines should never be relied on as a substitute for proper assessment with respect to the particular circumstances of each case and the needs of each patient. Clinicians should also consider the local skill level available and their local area policies before following any guideline.
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Paediatric Improvement Collaborative Clinical Practice Guideline
The following guideline has been endorsed by the National Paediatric Improvement Collaborative and should be used in conjunction with the relevant local guidelines.
The above link will take you to an external website.
Management of hyponatraemia pain at Perth Children’s Hospital follows the evidence-based guidelines from the National Paediatric Improvement Collaborative (PIC).
The guideline should be used in conjunction with local policies and guidelines pertinent to the management of hyponatraemia in your health service.
Please refer to the PIC Guidelines disclaimer.
Should you have any suggestions around improving the PIC CPGs, please complete the feedback form on the CPG website.
Nursing considerations
- Any hospitalised child is at risk of hyponatraemia whether receiving enteral or intravenous fluids.
- Children with hyponatraemia should be monitored closely for altered neurological status and any concerns should prompt a medical review.
- Accurate daily weight, fluid intake, fluid output and balance should be recorded in all patients with hyponatraemia.
- Sodium chloride 0.9% with glucose 5% should be the intravenous fluid of choice in children at risk of developing hyponatraemia.
- Children with confirmed hyponatraemia should have their electrolytes measured every 4 hours until stable.
- Complete and record a full set of observations on the Observation and Response Tool and record additional information on the Clinical Comments chart.
- Escalate care according to the Early Warning Score Escalation pathway.
- Complete a full set of neurological observations if clinically indicated.