Hypernatremia

• What is the threshold for hypernatremia in mEq/L?

  145 mEq/L
• What causes hypernatremia?

  Loss of water or gain of sodium
• What is the greatest protection against hypernatremia in healthy individuals?

  Thirst or access to water
• Which client is at risk for hypernatremia?

  Client with decreased consciousness
• What are sodium-containing drugs associated with hypernatremia?

  Sodium bicarbonate
• What are some symptoms of hypernatremia?

  Dry skin, headache, and seizures
• What changes in urinary output might indicate hypernatremia?

  Changes in thirst and urinary output
• What vital sign change is associated with hypernatremia?

  Tachycardia
• What are the interventions for hypernatremia?

  • Restrict dietary sodium intake
  • Monitor intake in older adults or cognitively impaired
  • Fluid replacement: isotonic for mild, hypotonic for severe
  • Gradually reduce serum sodium levels
  • Use diuretics if sodium is high with normal-excess fluid
• What is the goal of treatment for sodium excess?

  To dilute sodium with IV fluids
• What type of fluid should be administered for mild hypernatremia with decreased fluid volume?

  Isotonic fluid
• What type of fluid should be administered for severe hypernatremia?

  Hypotonic fluid
• Why must serum sodium levels be reduced gradually?

  To prevent too rapid water shift into cells
• What happens if sodium is high with normal-excess fluid?

  Diuretics promote sodium excretion