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