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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. 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.
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