How do you confirm pseudohyponatremia?
How do you confirm pseudohyponatremia?
Pseudohyponatremia is an artefact; measured serum sodium is reduced but actual plasma sodium is normal. The condition can only arise if the serum lipid or protein concentration is markedly increased and plasma sodium is measured using either indirect ISE or flame photometer.
What is pseudohyponatremia and what conditions cause it?
The most common cause of pseudohyponatremia is due to severely elevated levels of cholesterol. [2] In serum blood samples taken from patients with severe hypertriglyceridemia, the sample may appear overtly lipemic, hyper viscous, or discolored from the overwhelming presence of insoluble triglycerides.
How do you calculate corrected na?
The proposed formula was: corrected sodium = measured sodium + [1.6 (glucose – 100) / 100]. The laboratory would then report a “corrected” serum or plasma sodium in addition to the measured sodium.
What is corrected sodium in DKA?
In DKA the overall mean corrected [Na] was within the normal range of [Na] (137–143 mmol/L).
How does hyperlipidemia and Hyperproteinemia cause Pseudohyponatremia?
In states of hyperproteinemia or hyperlipidemia, there is an increased mass of the nonaqueous components of serum and a concomitant decrease in the proportion of serum composed of water. Thus, pseudohyponatremia results because the flame photometry method measures sodium concentration in whole plasma.
Do you code Pseudohyponatremia?
As such, pseudohyponatremia cannot be coded, and coding efforts should focus on identifying the inciting cause.
When is corrected sodium used?
Use corrected sodium to evaluate dehydration If the corrected sodium concentration is normal despite a very high serum glucose concentration, either the patient has maintained adequate water intake or the onset of hyperglycemia was very acute.
Why is sodium low in diabetic ketoacidosis?
In DKA, we expect to find normal or low serum sodium due to the dilutional effect of hyperosmolar status caused by elevated blood glucose that shifts water from the intracellular space to the extracellular space.
Do you correct sodium for anion gap in DKA?
Patients with diabetic ketoacidosis (DKA) frequently have hyperglycemia. Serum sodium in these patients should not be corrected for hyperglycemia to calculate the anion gap for acidosis because extracellular fluid shifts caused by hyperglycemia will dilute serum chloride and bicarbonate.
How does glucose cause Pseudohyponatremia?
Hyperglycemia causes osmotic shifts of water from the intracellular to the extracellular space, causing a relative dilutional hyponatremia.
What is the ICD 10 code for Pseudohyponatremia?
ICD-10-CM Diagnosis Code E34 E34.
