Assessing acid-base balance, water balance, water intoxication, and dehydration
Potentiometric, Indirect Ion-Selective Electrode
Serum
Patient's age and sex are required.
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions:
1. Serum gel tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged, and the serum aliquoted into a plastic vial within 2 hours of collection.
If not ordering electronically, complete, print, and send a Cardiovascular Test Request Form (T724) with the specimen.
0.25 mL
Gross hemolysis | Reject |
Gross lipemia | OK |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 14 days | |
Ambient | 14 days |
Assessing acid-base balance, water balance, water intoxication, and dehydration
Sodium is the primary extracellular cation. Sodium is responsible for almost one-half the osmolality of the plasma and, therefore, plays a central role in maintaining the normal distribution of water and the osmotic pressure in the extracellular fluid compartment. The amount of sodium in the body is a reflection of the balance between sodium intake and output.
Hyponatremia (low sodium) is a predictable consequence of decreased intake of sodium, particularly that precipitated or complicated by unusual losses of sodium from the gastrointestinal tract (eg, vomiting and diarrhea), kidneys, or sweat glands. Renal loss may be caused by inappropriate choice, dose, or use of diuretics; by primary or secondary deficiency of aldosterone and other mineralocorticoids; or by severe polyuria. It is common in metabolic acidosis. Hyponatremia also occurs in nephrotic syndrome, hypoproteinemia, primary and secondary adrenocortical insufficiency, and congestive heart failure. Symptoms of hyponatremia are a result of brain swelling and range from weakness to seizures, coma, and death.
Hypernatremia (high sodium) is often attributable to excessive loss of sodium-poor body fluids. Hypernatremia is often associated with hypercalcemia and hypokalemia and is seen in liver disease, cardiac failure, pregnancy, burns, and osmotic diuresis. Other causes include decreased production of antidiuretic hormone (ADH; also known as vasopressin) or decreased tubular sensitivity to the hormone (ie, diabetes insipidus), inappropriate forms of parenteral therapy with saline solutions, or high salt intake without corresponding intake of water. Hypernatremia occurs in dehydration, increased renal sodium conservation in hyperaldosteronism, Cushing syndrome, and diabetic acidosis. Severe hypernatremia may be associated with volume contraction, lactic acidosis, and increased hematocrit. Symptoms of hypernatremia range from thirst to confusion, irritability, seizures, coma, and death.
<1 year: not established
> or =1 year: 135-145 mmol/L
Symptoms of hyponatremia depend primarily upon the rate of change in sodium concentration, rather than the absolute level. Typically, sodium values less than 120 mEq/L result in weakness; values less than 100 mEq/L result in bulbar or pseudobulbar palsy; and values between 90 and 105 mEq/L result in severe signs and symptoms of neurological impairment.
Symptoms associated with hypernatremia depend upon the degree of hyperosmolality present.
No significant cautionary statements
Tietz Textbook of Clinical Chemistry. Edited by CA Burtis, ER Ashwood. WB Saunders Company. Philadelphia, PA, 1994
Ion-selective electrode (ISE) (indirect potentiometry). The ISE module performs indirect measurement of electromotive force (EMF). The ISE module measures the EMF difference between an ion-selective electrode and a reference electrode. The EMF of the ion-selective electrode is dependent on the ion concentration of the sample. The EMF of the reference electrode is constant. An electronic calculation circuit converts EMF of the sample to the ion concentration of the sample.(Package insert: Roche Diagnostics ISE reagent; Indianapolis, IN, 2006)
Monday through Sunday
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
84295
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
NAS | Sodium, S | 2951-2 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
NAS | Sodium, S | 2951-2 |