hey everyone it's Sarah with registered nurse rn.com and in this video I'm going to be going over hypernia in my previous video I covered hyponatremia and in this video I'm going to highlight the causes the signs and symptoms and the nursing interventions and I'm going to give you some pneumonics to help you remember this information and I'm going to highlight the things that you need to know for your nursing lecture exams and for the inlex now after this video be sure to go to my website register nurse rn.com and take the free quiz that goes along with this lecture it's going to test you on hypo and Hyper nutria and point out things that you'll probably need to know for your lecture exams and a card should be popping up so you can access that or a link in the description okay so let's break this word down because anytime you have one of these big words always try to break it down so you know what electrolyte you're dealing with okay hyper the first part of it means EX exessive n a is the prefix for sodium and anemia means blood so when you put all that together you get excessive sodium in the blood now what is a normal sodium level a normal sodium level is 135 to 145 mil equivalents per liter anything over 145 is considered hyper nutric now let's talk about the role of sodium in the body because in order to understand the causes the signs and symptoms why your patient is looking that way you need to know how it's working in the body and what's going on okay sodium is a very important electrolyte that helps um water move from inside the cell and outside the cell it plays a big role in that and sodium and water absolutely love each other wherever sodium congregates water wants to go to that so remember that that'll help you understand what's going on in the body and I actually have some video a video on tonicity of fluids where I cover hypertonic hypotonic and isotonic you may want to check those out to understand what's going on with the cell whenever these conditions are presenting and what type of fluids are for that because in nursing school you have to know those things okay let's look at this through an illustration whenever you have hypernia what's going on to the cell well what's going on is that you have the inside of the cell which is called intracellular and then you have the outside of the cell which is extracellular whenever you're getting a blood test the blood test is measuring the amount of sodium that's outside of the cell it doesn't measure the inside so the blood test is picking up that there is a lot of sodium in the blood and whenever that happens you have sodium and water inside the cell and they are getting lonely and according to the rule of Osmosis things like to move from a lower concentration to a higher concentration so it's very lowly concentrated in the inside of the cell and it's very concentrated on the outside of the cell with all that sodium in there so what happens is that all this water rushes out of the cell to the extra cellular part of the cell and the cell shrinks it dehydrates and this is because of osmosis and whenever this happens it affects a lot of cells throughout the body and you start seeing all these signs and symptoms so let's look at the causes of hypernatremia why you're what's really causing this in order to remember this I suggest you remember the the phrase high salt because here we have excessive amount of salt so just remember high salt with each letter correlating with the cause so H for hypercortisolism this is with cushen syndrome remember with hypo nmia it was with ADD disease so remember that because those two are the opposite of each other really and this is just where hypocortisolism is where you have an over production of aldosterone and how aldosterone works because it's just so much in the body you're retaining lots of sodium and your potassium will actually go down and I talk about that in the hypokalemia videos but you're retaining lots of salt and hyperventilation can cause that as well now the other the eye you're going to have this can be caused by increased sodium intake either the patient is just eating lots of salt or um it's happened with an IV solution the other one G for GI tube feedings and this is where um maybe they're administering GI tube feedings and um whenever you do that you also give water supplements so maybe there wasn't enough um ordered for the patient to have a water supplement after the feeding or something like that and that sometimes in patients causes increased sodium levels next the other H for hypertonic Solutions um this is like the 3% saline next the other s for salt is sodium excretion decrease your body is actually retaining the sodium and it's not getting rid of it and drugs that like to cause that are corticosteroids next the a for aldosterone problems this goes back to your hyper cortisone ISM with with Cushings but you can also have where this again is just increasing the reabsorption of sodium you're retaining it next L is loss of fluids and this is where the patient becomes dehydrated such as with fever or sweating this can cause this condition and the other one impaired thirst they're just not thirsty and you see hyponatremia especially a lot in your elderly patients because or someone who doesn't have access to water fresh water okay so let's look at the signs of symptoms of hypernia how is this patient going to present to you as the nurse taking care of this patient what are things you're going to have to watch out for because tests like to hit on they'll give you some signs and symptoms maybe throws out a cause and ask you what electrolyte IM balance this is so remember the phrase no fried foods for you because fried foods they are full of salt they are not good for us so remember the word fried okay f for fever the patient's probably going to have a fever and have flush looking skin R for restlessness and really agitated they're going to be confused they're going to be on edge I in increase fluid retention you may see some admon swelling e for edema extremely confused and Confused like I said this is true I've had patients whose sodium levels have been through the roof and they are they were alert whenever I got them but then their sodium level went crazy and they get completely confused so that is definitely true and D for decreased urinary output and dry mouth and skin they're just going to be really dry their Skin's going to be fleshed so now let's talk about the nursing interventions and things that you need to know as a nurse when taking care of this patient now with nursing interventions you definitely want to commit these to memory because this is where a lot of test questions will come the scenario will give you like the sodium levels 170 what is a nursing priority for you so you'll want to make sure you understand these okay first the first thing you want to do is you'll want to restrict the patient sodium intake they already have a lot of sodium on board so you don't want them to intake anymore so know your foods that are really high in salt because test questions will give you a scenario and list all these foods and they'll say which one do you not want the patient have and just to highlight bacon butter any canned foods that's a tricky one cuz a lot of people don't think um canned foods are bad with salt intake cuz uh the scenario might say oh I'm want to buy canned corn well that sounds good because it sounds like a vegetable but it's high and salt so make sure you know that cheese Hot Dogs lunch meat processed foods and table salt next you'll want to ensure patient safety because they're confused and agitated make sure you have the call and reach that you're maybe have to move them closer to the nursing station so you can watch them next um this is another big one MD May order an isotonic or a hypotonic IV solution because remember what's happened is your cell is shrunk up and dehydrated and we need to move some fluids into that cell to get it back normal so they may order um 0 45% of sailing that's the biggie that's what they normally order but some things you need to know about whenever you're giving this you want to give this slow slowly because this is causing the shifting of the fluids and you don't want to give it too much where you push all that fluid in and that cell expands too much so you need to watch out for cerebral edema in the patients any signs of confusion anything like that knowing that hey we're giving too much fluids to this patient we're shifting them too fast because we want to do this slowly over time and then last but not least you want to educate the patient on proper diet especially if they're going home and they're at risk for hyperia FS they need to avoid eight the signs and symptoms of an increased sodium level okay so that was about hypernatremia now be sure to take the quiz at register nurse rn.com to test your knowledge between hypo and hypernatremia and check out my other videos on electrolytes imbalances and thank you so much for watching and please consider subscribing to this YouTube channel