Hypernatremia

Question 1

How is hypernatremia defined?

Answer 1

Sodium concentration over 145 mEq/L
Typically, hypovolemic due to free water losses
Rarely excessive sodium intake may cause hypernatremia
Intact thirst mechanism and access to water are the primary defense against hypernatremia

Question 2

What are the signs and symptoms?

Answer 2

Hypotension and oliguria

Early signs are lethargy, irritability, and weakness.

Severe signs are hyperthermia, delirium, seizures, or coma. (158 sodium or higher)

Question 3

How do you treat hypernatremia?

Answer 3

Correcting cause of fluid loss
Replacing water
Replacing electrolytes
Fluids should be administered over a 48 hour period
Aiming for 1 serum sodium correction

Question 4

What can rapid correction of hypernatremia cause?

Answer 4

Cerebral edema