Strength in Numbers: A Team-Based Approach to Managing Patients with Hyponatremia (Part 1)

This virtual patient panel provides learners with real-world application of best practices among various members of the healthcare team in the management of patients with hyponatremia. A patient case is provided, followed by discussion among the team members to provide insight and context to why particular courses of action were chosen.


This activity has been designed to meet the educational needs of health care professionals involved in the diagnosis, treatment and management of patients with hyponatremia, which commonly occurs as a complication in patients with dysfunction of the heart/liver/kidneys, or in patients in the neurocritical care setting.


Upon completion of this activity, participants will be better able to do the following:

  1. Recognize risk factors for development of and describe the impact of hyponatremia in hospitalized patients and potential consequences of failure to treat appropriately.
  2. Review complications associated with hyponatremia in high-risk patient populations such as neurocritical care and heart failure.
  3. Describe the potential value of using copeptin levels as a surrogate marker of AVP activity and identification of risk in patients with heart failure.
  4. Discuss different etiologies of hyponatremia and appropriate treatment options for the respective etiology.
  5. Implement a plan to monitor hyponatremic patients post-discharge and maintain normonatremia once out of the hospital setting.
Click here to be taken to Part 2


Kirkwood Adams, MD
Associate Professor of Medicine and Radiology, Division of Cardiology
University of North Carolina School of Medicine
Chapel Hill, NC


Denise Rhoney, PharmD, FCCP, FCCM, FNCS
Ron and Nancy McFarlane Distinguished Professor and Chair of the Division of Practice Advancement and Clinical Education
University of North Carolina Eshelman School of Pharmacy
Chapel Hill, NC


K. Melissa Smith, DNP, ANP-BC, CHFN
Nurse Practitioner, Nashville General Hospital Heart and Vascular Center
Instructor, Vanderbilt University School of Nursing
Nashville, TN


Disclosure of Conflicts of Interest

It is the policy of the Elsevier Office of Continuing Medical Education that all faculty, instructors, and planners disclose any real or apparent conflicts of interest relating to the topics of this educational activity. 

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

FacultyRelationship Identified With:

Kirkwood Adams, MD

Grant/Research Support: Otsuka America Pharmaceutical, Inc.

Denise Rhoney, PharmD

No relationships to disclose.

K. Melissa Smith, DNP

No relationships to disclose.

Non-faculty: Steven Scrivner, MPA, CHCP; Sandy Breslow; Alison Kemp; and Bernard M. Abrams, MD, hereby state that neither they nor their spouse/life partner have had any financial relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months.


This CME activity has been peer-reviewed by The American Journal of Medicine.

Financial Support

This activity has been supported by an independent educational grant from Otsuka America Pharmaceutical, Inc.

Provider Information

Jointly provided by the Elsevier Office of Continuing Medical Education and Novus Medical Education.

CME Credit (Physicians)

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Elsevier Office of Continuing Medical Education and Novus Medical Education. The Elsevier Office of Continuing Medical Education is accredited by the ACCME to provide continuing medical education for physicians.

The Elsevier Office of Continuing Medical Education designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


For all CME inquiries or special needs, please contact

Disclosure of Unlabeled Use: This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The Elsevier Office of Continuing Medical Education, Novus Medical Education, and Otsuka America Pharmaceutical, Inc. do not recommend the use of any agent outside of the labeled indications.

Disclaimer: Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Course summary
Available credit: 
  • 0.50 AMA PRA Category 1 Credit(s)™
  • 0.50 Non-physician
Course opens: 
Course expires: 

Available Credit

  • 0.50 AMA PRA Category 1 Credit(s)™
  • 0.50 Non-physician
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