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Hypernatremia

Pang-Yen Fan, MD and Rajarshi Bhadra, MD Reviewed 06/2021
 


BASICS

DESCRIPTION

  • Defined as serum sodium (Na) concentration >145 mEq/L , which usually represents a state of hypertonicity (1,2)

  • Na concentration reflects balance between total body water (TBW) an...

DIAGNOSIS

HISTORY

  • History of conditions leading to water loss or impaired thirst: nausea, vomiting, diarrhea, polyuria, fever, heat exposure, extreme exercise, brain injury 

  • Neurologic symptoms are comm...

TREATMENT

GENERAL MEASURES

  • The treatment of hypernatremia involves treating the underlying cause and correcting the water deficit.

  • Determine the duration of hypernatremia as speed of correction depends ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Frequent neuological checks during acute correction

  • Daily weight, electrolytes, and blood glucose for a period immediately after correction

  • Period...

REFERENCES

1
Adrogué  HJ, Madias  NE. Hypernatremia. N Engl J Med.  2000;342(20):1493–1499. [View Abstract on OvidMedline]
2
Sterns...

SEE ALSO

  • Diabetes Insipidus

  • Algorithm: Hypernatremia

CODES

ICD10

  • P74.21 Hypernatremia of newborn

  • E87.0 Hyperosmolality and hypernatremia

SNOMED

  • 237841006 Hyperosmolality with hypernatremia

  • 7405009 Acute hypernatremia

  • 12403008 Chronic hypernatremia

  • 72452005 Cer...

CLINICAL PEARLS

  • Occurs from water deficit in comparison to total body Na stores

  • Common causes include dehydration, DI, impaired access to fluids.

  • Avoid rapid correction of chronic hypernatremia to preve...

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