#hypernatremia

[mcatmemoranda]

We have a pt who is hypernatremic. So we asked nephro how to correct it. His sodium is 159. Nephro said to use hyponatremic fluid (e.g., D5W) to correct the sodium to a goal of 150 mg/dL over 24 hours. So you calculate the pt's free water deficit (I used MD Calc to do it), then divide the free water deficit by 24 hours. Or, if you don't want to make the pt's blood glucose go too high, you can use 1/2 normal saline, but double the amount. My pt is pre-diabetic, so I'm going to use 1/2 normal saline. His free water deficit is 6.5 L. 6.5 L/24 hours = 0.27083 L/hour. 0.27083 x 2 = 0.54 L/hour.

[mission-to-dietitian]

HyperVOLEMIC are sodium gain patients.

Water loss is HYPOvolemic patients (so, extra renal and renal water losses, like diaphoresis/insensible water loss, osmotic diarrhea)

Diabetes insippidus presents as EUVOLEMIC hypernatremia.

Giving too much NaHCO3 can also cause hypernatremia.

Free water deficit at 00:59:59 https://youtu.be/dmHEVM-mPTg?feature=shared

[experthomeopathy]

When blood sodium is high - Symptoms, Cause, Treatment, Test

Hypernatremia or high sodium level is a condition of electrolyte imbalance and is shown by an elevated degree of sodium in the blood, The ordinary grown-up for sodium is 136-145 mEq/L. Sodium is a component, or an electrolyte, that is always present in the blood. Hypernatremia is an ailment where the sodium level is excessively high. This generally comes from lack of hydration, when there isn't sufficient water in that frame of mind to weaken the sodium appropriately. It's additionally conceivable to foster hypernatremia if a lot of salt enters the body, yet this is more uncommon. In hypernatremia, the degree of sodium in blood is excessively high. Sodium is an electrolyte that is in your blood and the liquid that encompasses cells. Your sodium level is a proportion of how much salt and water is in your body. Hypernatremia includes lack of hydration, which can have many causes, including not drinking an adequate number of liquids, the runs, renal dysfunction, and diuretics. Typically, liquids are given intravenously to gradually lessen the sodium level in the blood.

Cause of high sodium level in blood

For the most part, hypernatremia results from lack of hydration. At the point when individuals lose body liquids and become dried out due to

Body fluid lacking from not drinking sufficient water

Sudden starts, severe vomiting

high fevers

Having loose bowels

Use of diuretics for fewer micturitions in certain conditions

Perspiring unreasonably

You might eat a lot of salt with your foods

Drying out from not drinking sufficient water

Medications like steroids, licorice, and certain blood pressure medicines

A few circumstances, for example, diabetes mellitus, aldosteronism and so on

Normal value of blood sodium

136-145 mEq/L

Read more

[blackwaxidol]

Norovirus outbreak 👍

[soysaucevictim]

I love people dunking on Ji/lly Juice.

I just can't help but think "this is how you completely botch making kimchi or sauerkraut." :I

[arclyn64]

imagine wanting to feel like a badass while playing video games I want games that make me feel like I'm going to die in real life

[celestial-clownz]

super cute Lacey intricate loungewear vs anime shirt anyways Martyn is such a loser do you think he’d die of hypernatremia

[pokemonshelterstories]

I work at a riding stable, and one of my co-workers has been consuming the electrolytes intended for the Rapidashes and Zebstrikas as "Super-Feraligatorade".

Any chance you can give me some facts that I can use to make him fucking STOP?!

uh...how much is he taking? equine pokemon sweat in greater quantities than we do, and consuming an excess of electrolytes could result in hypernatremia.

if he's specifically taking zebstrika supplements (zebstrika and rapidash can't use the same electrolyte powder, as they have different electrolyte needs), that could cause additional problems. supplements intended for zebstrika are higher in copper on account of their typing, and excess copper consumption is detrimental to the human body.

in any case, it literally says "for use in equine pokemon only" on the side of these containers. he's going to explode his heart taking this stuff.

[tavyliasin]

The Doors to the House of Hopeful Sinners are OPEN

Hello darlings~ The doors to my experimental server are now opening, following the success of the experiment~ (I know the banner isn't particularly original yet but we're open to submissions to replace it!)

The House of Hopeful Sinners is an open and inclusive 18+ FanServer for Baldur's Gate 3, with a focus on creative fanworks and supporting fellow fan creators!

To learn more about the server and what we hope to create together, please Read More below! (NSFW Content and Humour Follow)

HOHS Server Principles

A general summary of the server is that it is a space to allow creativity to flourish. We are LGBTQIA+ and NeuroDivergent Friendly, our motto is something along the lines of "Horny But Wholesome", or "Spicy Kindness". Do be aware we do not currently spoiler mark any storylines, endings, or game details, so you may wish to finish everything in the game unless you're fine with spoilers. Some of what we have to offer:

Almost all channels are NSFW, hornyposting 24/7 is free for all to enjoy if you so wish. No judgement! BE FREE!

Dedicated forums for FanArt and FanFiction, so you can share and search for your own works or those by others.

Forums for reference materials and lore discussion to use for fanworks.

Optional ping roles to be alerted to new content with your favourite characters!

Starboard including NSFW Channels!

Specific channels and threads for discussing niche and triggering kinks where those who enjoy them can engage safely.

Clear list of CWs and rules to tag and spoiler hide content containing potentially triggering content.

Voice Channels to stream games, art, or just chill with your fellow sinners.

A selection of custom emojis, stickers, and soundboards!

A community who will welcome you whether you only drop by a little or visit often. Lurkers welcome~ Enjoy the space however you wish.

Space to grow! We are more than willing to hear feedback and build our space around the needs of the community.

Simple age verification. Open a ticket to verbally confirm your age with a moderator, no photo ID needed. This is trust, and breaking it is an immediate lifetime ban. Having under 18s around is not safe for minors or for the adults. If you're too young, please respect this and wait. We will never knowingly allow a minor into this space.

Bots for AO3 link summaries and image/video embeds from Twitter, Tiktok, Instagram, etc

Writing Sprint Channel and bot to write alongside friends and spur each other on!

Server Reviews!

You don't just have to take my word from it, listen to these reviews from satisfied community members!

1/5 stars. "Not enough Raphael." - A. Devilyoudo 5/5 stars. "Like 24/7 Horny Jail, now with a token SFW channel!" - I.C.U. Peekin 3/5 stars. "Server owner clearly needs more sleep." - B.D. Thyme 5/5 stars. "Finally, a place where I have threads for less common kinks!" - I.P. Freely 3/5 stars. "The creative energy gave me kinks I didn't know I had so now I have that to deal with." - Sweet E Pye 5/5 stars. "Everyone is so feral I'm making a fortune." Mr Phucks, Cage Chewer Dentistry 0/5 stars. "These degenerates have changed my brain chemistry and all I can think of is eating Gortass." - Tsun Derriere 5/5 stars. "I've accidentally become the Fairy Smutmother to a bunch of brats and couldn't be happier." - Tavylia of House Sin, first of her na- (script cuts off) 3/5 stars. "A good selection of smut content but I'm too scared to talk to everyone." - Lou King (respectfully) 2/5 stars. “I’ve seen less horny pornography. I had to turn off my message previews so I didn’t give my coworkers hypernatremia at the sheer volume of cum present.” - Michael Toris 5/5 Stars. “I think I’m growing a prostate where my frontal lobe used to be. Think Durge is into skullfucking?” - Illa D. Vized 5/5 stars. "A full range of penis emojis." - Forrest F. Cox 5/5 stars "There's a reason I'm here every day" - Leonardo DaVinci 5/5 stars. "I have learned things about prostates, cervical mucus, and fertility my health class never bothered with and there are big enough nerds here that there are NIH citations about it." - Prof G Dekarios

What Else is there in HOHS? Beta Readers

We have dedicated Beta Readers on a tag role - we would welcome more Beta Readers to help polish up our writers' works, though of course time is freely given and boundaries/CWs are always respected. You are under no pressure to beta. But what can that feedback look like? How does it help?

Editing is painful, but having useful feedback alongside fun and excited comments is a great way to make it a lot less horrible!

Treatos! WIP Feedback!

Sometimes to get things flowing we like to write "Treatos" - short paragraphs/drabbles not connected to full fics to help us get the creative mode moving again.

Most of all, we just welcome all Hopeful Sinners who share our values in fandom enjoyment~ I hope to see you there! - With Love, Tavylia Sin

Disclaimer - side effects of exposure to HOHS might include: - Gender Euphoria - Producing more creative works - Persistent feelings of self-worth - Hyperfixation go brr - Interest in characters you didn't look twice at before - Excessive Thirst

[zooophagous]

Favorite YouTube channel?

Chubbyemu

Doctor Benjamin breaks down energency room cases to their bare bones to help you understand step by step what went wrong and how to fix it.

Things like "this person has hypernatremia, hyper meaning too much, Na referring to sodium, and emia meaning presence in blood. High sodium presence in blood. This is how it causes brain damage..."

He takes concepts like organic chem and walks you through it in layman's terms so you come away with new vocabulary and a new understanding of how your body works. It's a great channel for picking up buzzwords that make you sound super smart.

He also has a very level headed and compassionate affect that doesn't come across as mocking or judgmental even if the case is something ridiculous that the patient should have known better about.

Hands down my favorite educational channel on the website.

If you're like me and you like watching "fix it" videos where filthy houses or cars or whatever get cleaned by a professional, but also have a sort of morbid curiosity, Crime Scene Cleaners is a good one too. They clean up the aftermath of severe injuries and unattended deaths as well as flooding or hoarding or other types of extreme clean up. It's very sad at times but very satisfying to see them take something ruined and remove that terrible burden from the people left behind.

[ihatemybody1111]

TIP ON HOW TO THR0W 🆙 (TW)

KEEP IN MIND I FOUND ALL OF THESE RECS ON A WEBSITE THATS WHY JTS SO FORMALISH IDK SNYWAH BE CAREFUL IF YOU DO THIS One of the biggest risks of inducing vomiting is the possibility of causing a pneumonia!

1.There is a point at the front of your throat that can be squeezed to stimulate the vomiting reflex. To reach it, you should place a finger in your mouth, and slightly press down on the area behind the tongue, where your throat starts. The desire to vomit will appear almost immediately, although some people will need to do this 2 to 3 times to be able to vomit, as the brain may try to block the signal the first few times.

2. Instead of touching or poking the back of your throat with a finger or other instrument to stimulate a gag reflux, it can also be triggered by gargling (with water, for example). Gargling should be intense enough to induce gagging and retching, which is a forceful contraction of the stomach, so that stomach content will flow back up.

3. Some people may have a heightened sensitivity to certain sensory stimuli that may provoke vomiting. These stimuli can include auditory elements (e.g. hearing someone vomit), smells (like imagining the smell of vomit or other strong chemicals like bleach), and thinking about tasting of unappealing food.

4. Although they are no longer recommended, salt-water mixtures are thought to upset the stomach, cause contraction and induce vomiting. It is also important to highlight that sodium solutions are associated with a risk of hypernatremia, which is a salt toxicity that can be life-threatening when sodium levels in the blood are severely elevated.

[mcatmemoranda]

Drinking 3 L a day helps prevent progression of chronic kidney disease.

We were consulted for a pt with hypernatremia. He came in with hyperglycemia-induced osmotic diuresis and was in DKA. He has a free water deficit. He needs repletion of the free water. He has a 4.3 L free water deficit. His sodium was 160. If you want to correct his sodium to 150 in 24 hours, you need to give 2 L of free water ( this is based on the free water deficit calculator; but the calculator does not account for insensible water losses which are about 1 L a day, so we would have to give him 3 L of free water). Some of the free water he can drink, but the rest it will be IV. We decided to give 250 L of free water every 3 hours by nasogastric tube. Fluids always confused me. Giving normal saline is not giving free water. we could give 1/4 normal saline (which contains 750 cc of free water and 250 cc normal saline). 1 L of 1/2 normal saline has 500 cc of free water and 500 cc of normal saline. we decided to give him 1/4 normal saline.

There is a book that talks about renal physiology called Renal Pathophysiology by Burton D. Rose and Helmut G. Ronke.

[killed-by-choice]

“Phyllis Roe” (USA 1970–1972)

A study published in the Obstetrics and Gynecology medical journal documented 10 cases of maternal death from legal saline abortions in New York City. All of the women in the study had undergone their abortions thanks to New York’s pre-Roe legalization and had died between July 1, 1970 and June 30, 1972.

While nine of the cases appear to match some of those documented in another study, the person who was given the designation “Case 3” did not appear to match any known report. (She is given a pseudonym here to avoid dehumanizing her by reducing her to a number.) In addition, her postmortem findings were found to be suspicious considering the listed cause of death.

“Phyllis” underwent her saline abortion at approximately 18 weeks pregnant. The hazardous method was performed by a New York City hospital, apparently as an outpatient procedure. After receiving the hypertonic saline injections, she was discharged.

The next day, Phyllis returned to the hospital with a fever of 104 degrees. After delivering her dead child, she continued to bleed. Vacuum aspiration was performed and the hospital began treating her for septic shock and abnormally decreased urine output.

Even though she had been healthy with no history of serious illness, Phyllis died in three days. Her postmortem report showed peculiar results which may cast doubt on whether or not her complications had been diagnosed and treated correctly.

Even though Phyllis’s diagnosis during her hospitalization had been septic shock, her blood cultures showed no growth at all. Cervical cultures were reported to have grown “multiple organisms,” but did not list what organisms, whether or not they were infectious or which species were likely to have caused her death. Her uterus, which would most likely have been the site of initial infection, had “no gross evidence of infection” and there was a note that “microscopic preparations were not available”.

Phyllis had both air and fluid in her pleural space. She had been suffering from generalized tissue edema which was stated as “being suggestive of fluid overloading.” Despite all of these findings (and in some cases lack of them), her cause of death was still given as sepsis.

The study that later recorded Phyllis’s death regarded the autopsy findings with some degree of skepticism. While the study listed the diagnosis of sepsis as her cause of death, the authors wrote that “the description of [her] uterus must be considered as questionable.”

Analysis

What really happened to Phyllis? While at this point it may be impossible to know for sure, there are several possible explanations for the suspicious postmortem findings. One is that she really did die of sepsis, but that the lab work was mishandled. If, as the study noted, the description of her uterus was questionable, it could be possible that it was simply poorly examined.

Another possibility is that Phyllis was misdiagnosed and that the hospital decided to list her cause of death as a match for her initial diagnosis to avoid suspicion of malpractice. That may explain why important microscopic preparations were reportedly “unavailable.”

The findings of the autopsy may also indicate that Phyllis may have suffered another complication from saline abortion: hypervolemic hypernatremia. Hypernatremia, an electrolyte imbalance from dangerous levels of salt in the body, had already been well-established to have killed saline abortion clients by the time Phyllis was killed. If this had been the case for her, it could have caused hypervolemia as her body desperately tried to hold onto fluids to regulate her osmotic levels. This is highly consistent with the observations of generalized edema and fluid overloading and could also have explained her abnormalities in urine output. She also suffered disseminated intravascular coagulopathy or DIC, a well-documented symptom in many abortion deaths involving saline in the bloodstream.

(Considering that the same hospital had been responsible for the abortion and for treatment during Phyllis’s last days of life, there is a possibility that they would have an additional incentive to give her cause of death as sepsis. While still avoidable, sepsis could also have happened after birth, stillbirth or miscarriage, making a death from abortion-related sepsis seem more of an “acceptable” risk to some. However, death by hypernatremia after a massive dose of hypertonic saline in the bloodstream would not have occurred naturally for any of these, making her death without a doubt the result of the hospital’s actions.)

Yet another possibility combines some of the others: that the diagnosis of sepsis was correct and that Phyllis was suffering from undiagnosed hypernatremia. A study conducted decades after her death found correlations between hypernatremia and risk of developing sepsis. Both sepsis and hypernatremia can also cause similar problems such as kidney dysfunction, so it is possible that Phyllis died of a combination of complications. Her DIC could be explained by saline in the bloodstream, sepsis or both.

At this point it may not be possible to know for sure which exact complications killed Phyllis. What was never in doubt, however, is that she and her baby were two more preventable deaths from pre-Roe legalized abortion in New York City.

(All above images are from the study)

[macrophagee]

It’s fun to notice when college has completely broken your will to argue. Yeah, sure, hypervolemia is a sodium issue and hypernatremia is a water issue. Sure, professor. Why not.

[altocat]

Hello Sephiroth, who is your favorite celebrity?

Lucrecia Crescent is your mother's name and she has long brown hair she ties with a ribbon and she likes light purple.

-definitely Not Salty, who definitely is still trapped in the labs and didn't give Hojo hypernatremia and didn't bribe the Turks and definitely isn't currently on the run with a bunch of chocobos

"....Should I say that my favorite celebrity is Lucrecia Crescent?"

(audience laughter, Sephiroth looks visibly ill despite the joke)

[forfuckssakejim]

“SHOTS! SHOTS! SHOTS!” I shout, walking into a residents room with a cup full of reconstituted sodium polystyrene sulfonate suspension for their hypernatremia.