Published - Tue, 26 Jul 2022

HYPERNATREMIA

HYPERNATREMIA

The medical word for having too much sodium in the blood is hypernatremia. An essential ingredient for the body's healthy operation is sodium. The blood contains the majority of the sodium in the body. It is also an essential component of the lymph fluids and cells in the body. A rise in serum sodium concentration to a number above 145 mmol/L, which is considered normal between 136 and 145 milliequivalents per liter, is the definition of a common electrolyte issue. 



CAUSES

1. Reduced water intake can be caused by a defective thirst mechanism, unconsciousness, an inability to drink, or a lack of access to water.

2. Increased water loss can be caused by diarrhea, fever, diabetes insipidus, osmotic diuresis, hyperventilation, thyrotoxicosis, sweating, vomiting, and severe burns.

3. Increased sodium intake or renal salt retention is due to hypertonic saline ingestion or infusion, Cushing disease, congenital adrenal hyperplasia, hyperaldosteronism and sodium bicarbonate administration.


CLINICAL FEATURES

Symptoms:

Lethargy/lack of energy

Increased thirst

Confusion

Muscle irritability/twitches

Seizures

Tremulousness

Weakness

Coma


Physical examination findings: 

Dry mucous membranes

Flat neck veins

Orthostatic hypotension

Poor skin turgor

Respiratory paralysis 

Tachycardia

Tonic spasms


EVALUATION

1. Laboratory studies should include a complete blood count (CBC); serum electrolyte panel; serum glucose, BUN, and creatinine levels; urinalysis, urine sodium level, and osmolality.

2. Electrocardiography: An ECG should be obtained.


THERAPY

1. Fluid replacement: The amount of water needed to correct hypernatremia can be estimated as follows:

Water deficit (L) = 0.6* (usual body weight in kg)* (measured Na+ concentration - desired Na+ concentration) / measured Na+ concentration

To increase blood pressure and tissue perfusion in cases of severe dehydration, normal saline or lactated Ringer solution should be provided.

After the perfusion has been restored, 0.45 percent saline is given to keep the urine production at 0.5 mL/kg/hour.

2. Sodium reduction: The rate of sodium reduction should not exceed 10 to 15 mEq/L/day. The goal is to reach a normal serum sodium value in 48 to 72 hours.


DISPOSITION

Admission: Symptomatic patients, with serum sodium concentration greater than 160 mEq/L (with or without symptoms), patients who require intravenous or pharmacologic correction of the sodium imbalance, and patients who have significant comorbid factors require admission.

Discharge: Before discharging a patient, the case should be discussed with a primary care physician and arrangements should be made for appropriate follow-up.

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Rigomo Team

Rigomo is a leading online education platform that offers a wide range of courses to help individuals enhance their skills and achieve their career goals. With our user-friendly interface and expert instructors, we strive to provide high-quality education to everyone, anytime and anywhere. Join us today and take the first step towards a brighter future.

Rigomo is an e-learning platform that was founded in 2019 by a team of dedicated professionals with a passion for revolutionizing the way people learn. The platform offers a range of online courses that cover various industries, including business, technology, healthcare, and more.

Rigomo's courses are designed to be interactive and engaging, with a focus on practical skills that learners can apply in their careers. The platform uses a combination of video lectures, quizzes, and hands-on projects to help learners master the subject matter.

Rigomo is committed to providing affordable and accessible education to people around the world. The platform offers a range of pricing options, including monthly and annual subscriptions, as well as pay-as-you-go options for individual courses.

Since its launch, Rigomo has received numerous accolades for its innovative approach to e-learning. The platform has helped thousands of learners across the globe acquire new skills and advance their careers.

As Rigomo continues to grow, the team remains committed to providing high-quality education that is accessible to all. The platform is constantly updating its courses and features to ensure that learners have access to the latest tools and technologies.

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