Hypernatremia

What happens in hypertonic hypernatremia?

The high sodium concentration draws water from the ICF to the ECF to balance the osmotic gradient.

What are the types of hypernatremia based on volume?

Hypovolemic Hypernatremia

Euvolemic Hypernatremia

Hypervolemic Hypernatremia

Hypovolemic Hypernatremia means what and cause

Water loss >> sodium loss; often due to over-diuresis (excessive urination).

Hypovolemic Hypernatremia Symptoms

Low blood pressure (orthostasis), fast heart rate (tachycardia), dry mucous membranes.

Hypovolemic Hypernatremia Treatment

Start with normal saline IV to stabilize blood pressure and heart rate, then switch to free water replacement.

Euvolemic Hypernatremia means what and cause

Water loss without a change in sodium, commonly due to diabetes insipidus.

Euvolemic Hypernatremia symptoms

Increased urination (polyuria), excessive thirst (polydipsia), tiredness (lethargy), and possibly seizures.

Euvolemic Hypernatremia treatment

Free water replacement and Vasopressin (DDAVP)

Hypervolemic Hypernatremia means and cause

Excessive sodium intake relative to water, such as from sodium overload.

Hypervolemic Hypernatremia symptoms

Swelling in the body, including peripheral and pulmonary edema.

Hypervolemic Hypernatremia treatment

Free water replacement plus a loop diuretic to help remove excess sodium and water.

When given the free water deficit, how to treat it:

Administer 50% of free water deficit in first 24 hours, then remaining 50% over 2-3 days

• this requires close monitoring of serum sodium

Do not exceed a sodium correction greater than 6-12mEq/L/day

• Risk cerebral edema