HYPERNATREMIA (electrolyte imbalance)

HYPERNATREMIA
  • It is a high concentration of sodium in blood
  • normal sodium level - 135 - 145 mEq/L.
  • Hypernatremia is defined as a serum sodium level more than 145 mEq/L
  • Dangerous Hyper sodium > 158 mEq/L leads to development of seizures in a patient.
Treatment - Diluted fluids (5% dextrose or N/2(0.45%) in 5% dextrose)

causes:

  • Loss of water from body like in extremely debilitated old patients having extreme thirst
  • Lactulose: osmotic diarrhea
  • Mannitol (excess doses)
  • Diabetes insipidus with loss of water



INVESTIGATION:
Urine osmolality
  • If osmolality is < 250 mOsm/L in case of Diabetes insipidus with polydipsia and no access to water. so here water loss in body occurs
  • If osmolality >400 mOsm/L in case of extreme sweating
- In asymptomatic hypernatremia - liberal water intake

- Volume of fluids correction in case of sodium↑ - 160mEq

TBW(total body water) X sodium actual - 145/145
                           




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