Hypernatremia

Question: How to correct hypernatremia? The recommended rate of sodium correction is 0.5 mEq/h or up to 10-12 mEq/L in 24 hours for patients with hypernatremia. If you have a patient with a Na concentration of 150 mmols/L and place them on 1/2 normal saline and re-check their Na in 4 hours, what would the ideal Na concentration at that time be according to the classic recommendation?

Answer: 148 = (150-[0.5 meq/hr x 4 hr])

Question: Why would a person with hypernatremia be confused and disoriented?

Answer: Perhaps this will explain Hypernatremia is an electrolyte disturbance consisting of an elevated sodium level in the blood (compare to hyponatremia, meaning a low sodium level). The most common cause of hypernatremia is not an excess of sodium, but a relative deficit of free water in the body. For this reason, hypernatremia is often synonymous with the less precise term dehydration. Water is lost from the body in a variety of ways, including perspiration, insensible losses from breathing, and in the feces and urine. If the amount of water ingested consistently falls below the amount of water lost, the serum sodium level will begin to rise, leading to hypernatremia. Rarely, hypernatremia can result from massive salt ingestion, such as may occur from drinking seawater. Ordinarily, even a small rise in the serum sodium concentration above the normal range results in a strong sensation of thirst, an increase in free water intake, and correction of the abnormality. Therefore, hypernatremia most often occurs in people such as infants, those with impaired mental status, or the elderly, who may have an intact thirst mechanism but are unable to ask for or obtain water. Inadequate intake of water, typically in elderly or otherwise disabled patients who are unable to take in water as their thirst dictates. This is the most common cause of hypernatremia. Inappropriate excretion of water, often in the urine, which can be due to medications like diuretics or lithium or can be due to a medical condition called diabetes insipidus Intake of a hypertonic fluid (a fluid with a higher concentration of solutes than the remainder of the body). This is relatively uncommon, though it can occur after a vigorous resuscitation where a patient receives a large volume of a concentrated sodium bicarbonate solution. Ingesting seawater also causes hypernatremia because seawater is hypertonic. Mineralcorticoid excess due to a disease state such as Conn's syndrome or Cushing's Syndrome Symptoms Clinical manifestations of hypernatremia can be subtle, consisting of lethargy, weakness, irritability, and edema. With more severe elevations of the sodium level, seizures and coma may occur. Severe symptoms are usually due to acute elevation of the plasma sodium concentration to above 158 mEq/L (normal is typically about 135-145 mEq/L). Values above 180 mEq/L are associated with a high mortality rate, particularly in adults. However such high levels of sodium rarely occur without severe coexisting medical conditions. Thank you

Question: What will happen to thirst in hypernatremia?

Answer: You will feel more thirsty because your body wants to reduce its concentration of sodium.

Question: hyponatremia and hypernatremia? What is the difference between hyponatremia and hypernatremia? Is one an abnormal low concentration of sodium and the other an abnormal high concentration? What else is the differance?

Answer: hyponatremia is a far more lethal in high doses

Question: Chronic Hypernatremia Treatment? I am a recovering bulimic who vomited heavily and frequently with a large amount of fluid expulsion. Add to that that the salt concentration in my binge foods was very high, and I find I have a case of mild chronic hypernatremia. The symptoms I have are moderate full-body fluid retention, loss of elasticity (doughy feel) to my skin, lethargy, fatigue and irritability. If I have something to drink, I immediately feel sicker, the swelling and irritability greatly increase. I am urinating infrequently and in small quantities, but it is not dark or concentrated. I have read that you treat this imbalance through fluid restriction, but I have also read that I should be drinking electrolyte replacement fluids. My case is not severe, and I have no health insurance so I can't see a doctor-- what can I do at home? Do I restrict fluids? If I should drink, how much should I have in a day and in what sort of increments? Water or pedialyte? Should I eat or not? Detailed help gets 10 points... thanks

Answer: It should be done in a hospital setting, your brain has adapted to the high sodium levels, but they do need to be decreased back to normal range (130-140), but slowly. the docs accoomplish this by giving you IV fluids that are a bit hyponatremic, and they monitor your sodium level constatly. If there's absolutely no way to get you into the hospital, keep eating, and drink water with a bit of salt

Question: Treatment of Chronic Hypernatremia? I am a recovering bulimic who vomited heavily and frequently with a large amount of fluid expulsion. Add to that that the salt concentration in my binge foods was very high, and I find I have a case of mild chronic hypernatremia. The symptoms I have are moderate full-body fluid retention, loss of elasticity (doughy feel) to my skin, lethargy, fatigue and irritability. If I have something to drink, I immediately feel sicker, the swelling and irritability greatly increase. I am urinating infrequently and in small quantities, but it is not dark or concentrated. I have read that you treat this imbalance through fluid restriction, but I have also read that I should be drinking electrolyte replacement fluids. My case is not severe, and I have no health insurance so I can't see a doctor-- what can I do at home? Do I restrict fluids? If I should drink, how much should I have in a day and in what sort of increments? Water or pedialyte? Should I eat or not? Detailed help gets 10 points... thanks

Answer: causes: Inadequate intake of water--typically in elderly or otherwise disabled patients who are unable to take in water as their thirst dictates ii. Inappropriate excretion of water--often in the urine, which can be due to medications like diuretics or lithium or can be due to a medical condition called diabetes insipidus iii. Intake of a hypertonic fluid (a fluid with a higher concentration of solutes than the remainder of the body). This is relatively uncommon, though can occur after a vigorous resuscitation where a patient receives a large volume of a concentrated sodium bicarbonate solution. so do the opposite to treat i guess... Treatment Rapid correction should be avoided because of the brain's adaptive response to hypernatremia and the potential risk of cerebral edema. The current recommendation is to lower the serum sodium concentration by about 0.5 mEq/L per hour and to replace no more than half the water deficit in the first 24 hours. The following formula can be used to calculate the water deficit (total body water, in kilograms, is 60% of lean body mass in men and 50% in women): Water deficit = total body water (serum sodium concentration ÷ 140 - 1) In patients with hypovolemic hypernatremia, normal saline solution is indicated initially to correct the intravascular volume deficit. When that is accomplished, more hypotonic fluids (eg, 50% normal saline) can be used. In patients with hypervolemic hypernatremia, removing the source of salt excess, administering diuretics, and replacing water are important to successful therapy. Patients with euvolemic hypernatremia usually require water replacement alone--either free water orally or an infusion of 5% dextrose in water.

Question: Patient gets lasix 40 mg. You monitor which lab: a)Na because lasix can cause hypernatremia;? b) K because lasix can cause hypokalemia; c) K because lasix can cause hyperkalemia; or d) none of the above

Answer: lasix can cause hypokalemia, it is a potassium depleting diuretic

Question: What is Hypernatremia?

Answer: Hypernatremia is an electrolyte disturbance that is defined by an elevated sodium level in the blood.

Question: when monitoring a trauma patient who has a crushing leg wound, what should we be alert of? A nurse monitoring a trauma patient who has a crushing leg wound should be alert for signs of: A. Tachycardia B. Hypernatremia C. Hypercalcemia D. Hyperkalemia First I immediately thought that the answer is A... but I'm not confident with my answer. can anyone help me answering this question for me please?

Answer: A Tachycardia typically refers to a heart rate that exceeds the normal range for a resting hheart rate (heartrate in an inactive or sleeping individual). In humans, this rate is usually based upon age, sometimes it can be very dangerous depending on how hard the heart is working and the activity B. hypernatraemia is an electrolyte disturbance that is defined by an elevated sodium level in the blood. c. Hypercalcemia is elevated calcium in the blood d Hyperkalemia is elevated potassium Based on the choices above I would go with D. I would go with D because in a trauma situation a pain med may be used to help the patient. If the patient has a urinary tract infection or something else with the kidney wrong the pain medications could cause Hyperkalemia

Question: In Apparent Mineralocorticoid Excess (AME) why is anti-natiuresis not accompanied by hypernatremia? Endocrine Q

Answer: Mineralocorticoids save Na in your body, but it save water to, so relatively spoken, there is no significant hipernatremia. Absolute values of Na are increased.