Elevated Serum or Plasma Sodium
Excessive parenteral sodium administration in an unconscious patient whose thirst mechanism is absent.
Excessive use of diuretics or other drugs leading to water loss in the patient who cannot compensate by intake of water.
Diabetes insipidus may be central (neurogenic), acquired nephrogenic, or congenital nephrogenic.
Mineralocorticoid or glucocorticoid excess from primary hyperaldosteronism and Cushing syndrome with or without ectopic adrenocorticotropic hormone (ACTH) production.
Insensible water loss through the skin in the patient unable to obtain water or swallow.
Clinical findings progress from somnolence to confusion, coma, and respiratory paralysis as the hypernatremia worsens.
Commonly Encountered Situations
Hypernatremia most frequently occurs in an ICU when excess intravenous (IV) sodium is given to an unconscious patient.
Suggested Additional Lab Testing
Urinary electrolytes to assess for diabetes insipidus.
Serum aldosterone to identify primary hyperaldosteronism 24-hour urine free cortisol to identify Cushing syndrome, with or without ectopic ACTH production.
Copyright © 2017, 2013 Decision Support in Medicine, LLC. All rights reserved.
No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. The Licensed Content is the property of and copyrighted by DSM.
Sign Up for Free e-newsletters
Infectious Disease Advisor Articles
- Homeopathy No Better Than Placebo for Respiratory Infections in Children
- CDC Director Says Congo Ebola Outbreak May Be Uncontainable
- CDC Updates Recommendations for Hepatitis A Vaccination for International Travel
- Long-Term HIV Pre-Exposure Prophylaxis May Induce Significant Microbiome Shifts
- 10th Child Dies in Adenovirus Outbreak at NJ Facility
- Oral Urinary Tract Infection Treatments
- Treating Pseudomonas aeruginosa Infections: Highlights From IDWeek 2018
- Local Gentamicin Application Ineffective in Treatment of Periprosthetic Joint Infection
- High-Dose Influenza Vaccination May Benefit Transplant Recipients
- Social Medicine: The Effect of Social Media on the Anti-Vaccine Movement
- GERD Diagnosis and Management Guidelines
- Improved Care Needed for People With HIV in Prison and After Release
- Novel Point of Care Respiratory Viral Testing Service Shows Potential
- A New Nucleotide Analog Is Well Tolerated, Efficacious Against HCV Genotype 1-4
- Many Linens Delivered To US Hospitals Contaminated With Mucorales Mold