Hypernatremia

Question 1

Causes of hypernatremia

Answer 1

Sodium gain and fluid deficit

Question 2

Causes of hypernatremia by fluid deficit

Answer 2

Dehydration
Diarrhea
Fever
Fluid shift out of intravascular space (third spacing) such as in burns
Diabetes insipidus
Heat stroke

Question 3

Causes of hypernatremia by sodium gain

Answer 3

Kidney failure
Hyperaldosteronism
Cushing syndrome
Corticosteroids
Hypertonic tube feeding

Question 4

Signs and symptoms

Answer 4

FRIED SALT

Flushed skin
Restless, anxious, confusion, irritable
Increased blood pressure and fluid retention
Edema
Decreased urine output
Skin is dry
Agitation
Low grade fever
Thirst: dry mucous membrane

Question 5

Intervention

Answer 5

1. Seizure precautions
2. Maintain strict intake and output
3. Monitor daily weight

Question 6

Treat hypernatremia from fluid deficit

Answer 6

1. Increase fluid intake
2. Give isotonic or hypotonic IV fluids
3. Normal saline
4. 5% dextrose in water
5. 5% dextrose in 0.45% sodium chloride

Question 7

Treat hypernatremia with sodium retention

Answer 7

Restrict sodium intake
Give thiazide diuretics, which promote sodium excretion
Be aware of hidden sodium in food and medicine

Question 8

What things need to be monitor when giving dextrose containing IV fluids to a client with diabetes

Answer 8

Blood glucose