Hypernatremia Lecture Notes

Introduction

• Presenter: Sarah from RegisteredNurseRN.com
• Topic: Hypernatremia
• Previous Video: Covered Hyponatremia
• Study Aid: Free quiz available on RegisteredNurseRN.com

Understanding Hypernatremia

• Definition: Excessive sodium in the blood.
• Normal Sodium Levels: 135-145 mEq/L
• Hypernatremia: Sodium levels over 145 mEq/L

Role of Sodium in the Body

• Function: Helps water move between intracellular and extracellular spaces.
• Sodium and water are closely related, influencing fluid movement within the body.
• Related concepts: Tonicity of fluids (hypertonic, hypotonic, isotonic).

Cellular Effects of Hypernatremia

• Intracellular vs. Extracellular: Blood tests measure extracellular sodium levels.
• Osmosis: Water moves from lower concentration (inside the cell) to higher concentration (outside the cell), causing cell dehydration and shrinkage.

Causes of Hypernatremia

• Mnemonic: "HIGH SALT"
  • H: Hypercortisolism (Cushing's syndrome, overproduction of aldosterone)
  • I: Increased sodium intake (diet or IV solutions)
  • G: GI tube feedings (insufficient water supplementation)
  • H: Hypertonic solutions (e.g., 3% saline)
  • S: Sodium excretion decreased (e.g., due to corticosteroids)
  • A: Aldosterone problems (linked to hypercortisolism)
  • L: Loss of fluids (dehydration from fever or sweating)
  • T: Thirst impairment (especially in elderly patients)

Signs and Symptoms

• Mnemonic: "No FRIED foods for you"
  • F: Fever, flushed skin
  • R: Restlessness, agitation
  • I: Increased fluid retention, edema
  • E: Extremely confused
  • D: Decreased urinary output, dry mouth and skin

Nursing Interventions

• Restrict Sodium Intake:
  • Know high-sodium foods: bacon, butter, canned foods, cheese, hot dogs, lunch meats, processed foods, table salt.
• Ensure Patient Safety:
  • Monitor confusion and agitation; ensure call button is within reach.
  • Possibly relocate patient closer to nursing station.
• IV Solutions:
  • Isotonic or hypotonic IV (e.g., 0.45% saline).
  • Administer slowly to prevent rapid fluid shift and cerebral edema.
• Patient Education:
  • Diet adjustments to avoid high sodium intake.
  • Recognize signs of elevated sodium levels.

Conclusion

• Next Steps: Take the quiz on RegisteredNurseRN.com to test knowledge of hypo and hypernatremia.
• Additional Resources: Other videos on electrolyte imbalances.
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