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
Psychiatry Advisor Articles
- Sertraline Effective for Treating Depression in Vascular Cognitive Impairment
- Hospitalization Rates in Schizophrenia—Lurasidone vs Quetiapine
- Ketamine-Induced Dissociative Symptoms Predict Antidepressant Response
- First Nonopioid Drug Approved for Managing Opioid Withdrawal Symptoms
- Psychopathology of Adults Affected by Pre- and Perinatal Factors, Family Functioning
- Video Games and Exercise as Alternative Therapies for ADHD
- How Parents Can Enhance Autism Treatment: Use of Intervention Strategies at Home
- Electroconvulsive Therapy Effective in Children With Autism
- Comorbid Autism Spectrum Disorder and OCD: Challenges in Diagnosis and Treatment
- The Cutting Edge of Schizophrenia Research: VR as Treatment for Psychosis
- HIV Viral Suppression Rates in Psychiatric Inpatients With Comorbid Substance Use Disorders
- Greater Wealth Associated With Lower Risk for Dementia in English Study
- Social Hygiene: Screening for Social Media Addiction in Adolescent Patients
- Effects of Depressive Symptoms on Cognition, Markers of Brain Aging
- Substance Abuse and Primary Psychosis: A Closer Look