Hypernatremia

Question 1

Normal range of sodium

Answer 1

135-145 mEq/L

Question 2

What is considered hypernatremic

Answer 2

> 145 mEq/L

Question 3

What is hypernatremia on a cellular level

Answer 3

Large amount of sodium congregated outside the cell
Osmosis -> sodium wanted to follow and be outside
Cell shrinks

Question 4

What does sodium do in the body

Answer 4

Helps regulate water intracellular and extracellular

Water wants to go where sodium goes

Question 5

Causes of hypernatremia

Answer 5

“HIGH SALT”
Hypercortisolism (Cushing’s syndrome + hyperventilation)
Increased Na+ intake (oral or IV routes)
GI feeding without adequate H2O supplement
Hypertonic solutions (ex. 3% saline)
Sodium excretion decreased (ex. Corticosteroids)
Aldosterone problems (increased reabsorption of sodium)
Loss of fluids (dehydrated, fever, sweating)
Thirst impairment (often in elderly)

Question 6

S&S of hypernatremia

Answer 6

“No FRIED foods for you”
Fever, flushed skin
Restless, really agitated
Increased fluid retention
Edema, extremely confused
Decreased urine output, dry mouth/skin

Question 7

Interventions for hypernatremia

Answer 7

• restrict Na+ intake
• make sure pt is safe (confused + agitated)
• MD may order an isotonic or hypotonic IV solution (0.45% NS)
• educate about diet and S&S of increased Na+ level

Question 8

What should be considered when giving 0.45% NS

Answer 8

• give slowly
• if given too fast, cell can expand too fast
• can lead to cerebral edema

Question 9

Foods to avoid in a sodium restricted diet

Answer 9

Bacon
Butter
Canned foods
Cheese
Hot dogs
Lunch meats
Processed foods
Table salt