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Concept Map #2 by Emily Custer

Disease Process

  • Hypernatremia is an excessive sodium level in the blood and extracellular fluids (more than 145 mEq/L)
  • It is caused by ingestion of large amounts of sodium without proportionate water intake or a loss of water from the body faster than the loss of sodium.
  • This is caused by insufficient ADH (especially with diabetes), loss of the thirst mechanism, watery diarrhea, and prolonged periods of rapid respiration.
  • Hypernatremia causes a fluid shift out of the cells owing to the increased osmotic pressure of interstitial or extracellular fluid.

Risk Factors

Signs and Symptoms

Risk factors for hypernatremia include:

  • the patient being dependent on someone to provide water such as infants, older nursing home residents, and the critically ill.

Signs and symptoms of hypernatremia include:

  • weakness, agitation
  • firm subcutaneous tissue
  • increased thirst, with dry, rough mucous membranes
  • drecreased urine output because ADH is secreted
  • increased heart rate, increased muscle irritability and twitching, increased muscle reflexes
  • restlessness progressing to confusion
  • edema

Hypernatremia

Refernece List

Lewis, S., Dirksen, S., Heitkemper, M., Bucher, L. (2014). Medical-Surgical Nursing: Assessment and Management of Clinical Problems, 9th Edition [VitalSource Bookshelf version]. Retrieved from http://pageburstls.elsevier.com/books/9780323086783

VanMeter, K., Hubert, R. (2015). Gould's Pathophysiology for the Health Professions, 5th Edition [VitalSource Bookshelf version]. Retrieved from http://pageburstls.elsevier.com/books/9781455754113

Treatment

Diagnostics and Labs

Treatments for hypernatremia include:

  • Oral or IV isotonic or hypotonic fluids such as 5% dextrose in water, or 0.45% sodium chloride in saline.
  • Promote excretion of excess sodium with diuretics.
  • Restricted dietary sodium.
  • Labs of a person with hypernatremia will show an increased serum sodium level and increased sodium osmolality concentration.
  • A diagnosis of hypernatremia is based on a serum sodium above 145mEq/L
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