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Mineralcorticoid excess due to a disease state such as Conn's syndrome usually does not lead to hypernatremia unless free water intake is restricted. Salt poisoning is the most common cause in children. [16] [17] It has also been seen in a number of adults with mental health problems. [11] Too much salt can also occur from drinking seawater or ...
[3] [27] Once the patient is stable, it is important to identify the underlying cause of hypernatremia as that may affect the treatment plan. [ 3 ] [ 27 ] The final step in treatment is to calculate the patients free water deficit, and to replace it at a steady rate using a combination of oral or IV fluids.
Rapid administration (equal to or exceeding 10 mL/min) of intravenous sodium bicarbonate into neonates and children under two years of age may produce hypernatremia, resulting in a decrease in cerebrospinal fluid pressure and, possibly, intracranial hemorrhage. Therefore, the rate of administration to such patients should not exceed 8 mEq/kg ...
Water intoxication, also known as water poisoning, hyperhydration, overhydration, or water toxemia, is a potentially fatal disturbance in brain functions that can result when the normal balance of electrolytes in the body is pushed outside safe limits by excessive water intake.
Loss of over 10% of total body water can cause physical and mental deterioration, accompanied by severe thirst. Death occurs with a 15 and 25% loss of body water. [4] Mild dehydration usually resolves with oral rehydration, but severe cases may need intravenous fluids. Dehydration can cause hypernatremia (high levels of sodium ions in the
Edema (fluid retention): A decrease in salt intake has been suggested to treat edema. [12] [28] Kidney disease: Excessive salt (sodium) intake, combined with an inadequate intake of water, can cause hypernatremia. It can exacerbate renal disease. [12]
Whether or not a someone is receiving treatment for diabetes insipidus, fluid administration should be done carefully because too much fluid can lead to hypernatremia and too little water can cause hyponatremia. Hyponatremia is typically maintained with careful synchronization of urine output and a normal saline infusion. [32]
In patients with hypernatremia and euvolemia, free water can be replaced using either 5% D/W or 0.45% saline. In patients with fatty-acid metabolism disorder (FOD), 10% solution may be appropriate upon arrival to the emergency room.