Hypernatraemia- Raised sodium

Sodium imbalances are encountered frequently in the community. While evaluating blood results in General Practice -this chart on A4Medicine can help clinicians formulate a management plan for patients with results suggesting hypernatremia or a raised Na level. Physiological response to a raised Na level is discussed to aid understanding followed with an emphasis on evaluation to ascertain the cause. With no clear guidelines on management, user is advised to take into account several factors as speed of onset, level, symptoms along with a clinical assessment to make a management plan

Hypernatremia-Frequent electrolyte disorder in hospitalized patients Caused by loss of water or gain of sodium or both Hyperosmolar condition caused by ↓↓ TBW relative to electrolyte content Often marker of severe underlying disease and associated with very high mortality rates of 40-60 % Always associated with and ↑ ed effective plasma osmolality and hence with a reduced cell volume Relatively rare in community and seen less than hyponatraemia In community often seen in septic elderly people ( eg CVA , dementia ) ○ ↑ sweating○ reduced oral intake and reduced renal concentrating mechanisms ( ie inadequate concentration of urine in face of restricted water intake )○ limited access to water...