Implementation of Urine Sodium Monitoring in Preterm Infants

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Nuxoll, Jenny

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2025-05-16

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Providing optimal nutrition to infants in the Neonatal Intensive Care Unit (NICU) is an essential component of growth and development. In the extremely low birthweight (ELBW) infant (less than or equal to 1000 grams) or infant born at less than 30 weeks’ gestation, the maintenance of adequate sodium levels has been shown to improve both growth and neurodevelopmental outcomes. However, this population is at risk for sodium deficiency in the first few weeks of life due to having premature kidneys that cannot effectively regulate sodium homeostasis. While utilizing serum sodium concentrations to monitor sodium levels in the neonate is widely accepted, recent literature suggests that urine sodium values may be more effective in guiding sodium supplementation in preterm infants and could decrease the number of blood draws these infants require. The purpose of this DNP project was to decrease the number of blood draws in ELBW infants or infants born at less than 30 weeks’ gestation that are associated with the monitoring of sodium supplementation. During the project timeframe, urine sodium levels were determined every two weeks. Oral sodium supplementation was based on the urine sodium algorithm. The number of blood draws endured by infants receiving sodium supplementation was monitored, as well as the weight percentile on their respective growth chart. It was determined that utilizing urine sodium monitoring resulted in fewer blood draws for infants receiving sodium supplementation. There was no effect on discharge weight as compared to serum sodium monitoring.

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Creighton University

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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University.

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