Hypernatremia Flashcards
What is hypernatremia?
Serum sodium level that exceeds 145 mEq/L
What are the four basic causes of hypernatremia?
Decreased sodium excretion.
Increased sodium intake.
Decreased water intake.
Increased water loss.
What are some things that can cause decreased sodium excretion? (4)
Corticosteroids
Cushing’s syndrome
Kidney disease
Hyperaldosteronism
What are some methods of increased sodium intake that can lead to hypernatremia? (2)
Excessive oral sodium ingestion
Excessive administration of sodium containing IV fluids
What are some of the risks for decreased water intake?
Fasting, NPO status
What are some of things that can cause increased water loss? (7)
Increased rate of metabolism Fever Hyperventilation Infection Excessive diaphoresis Watery diarrhea Diabetes insipidus
What are the cardiac signs and symptoms of hypernatremia?
Heart rate and blood pressure respond to vascular volume status.
What are the respiratory signs and symptoms of hypernatremia??
Pulmonary edema if hypovolemia is present
What are the neuromuscular signs and symptoms of early hypernatremia?
Spontaneous muscle twitches, irregular muscle contraction
What are the neuromuscular signs and symptoms of late hypernatremia?
Skeletal muscle weakness, deep tendon reflexes diminished or absent
What are the CNS signs and symptoms of hypernatremia? (3) (different ones for normovolemia, hypovolemia, and hypervolemia)
Altered cerebral function (most common manifestation)
Normovolemia or hypovolemia: agitation, confusion, seizures
Hypervolemia: lethargy, stupor, coma
What is the gastrointestinal symptom of hypernatremia?
Extreme thirst
What is the renal sign of hypernatremia?
Decreased urinary output
What are the integumentary signs and symptoms of hypernatremia? (3)
Dry and flushed skin
Dry and sticky tongue and mucous membranes
Presence or absence of edema, depending on fluid volume changes
What are the laboratory values that indicate hypernatremia? (2)
Serum sodium level that exceeds 145 mEq/L
Increased urine specific gravity.
