The Fluid, Electrolyte and Acid-Base Companion
Hypernatremic patients are always hyperosmolar.
sodium > 145 mEq/L
osmolality > 300 mmol/L
Hypernatremia is a plasma sodium concentration greater than 145 mEq/L.Since sodium is the major contributor to plasma osmolality,
hypernatremiaalways causes hyperosmolality
. The symptoms of hypernatremia are due tothe water shifts associated with hyperosmolality. (See Chapter 5,
page 89.)Because hypernatremia is always associated with hyperosmolality, thesame mechanisms which defend against hyperosmolality also defend againsthypernatremia. ADH and thirst are the primary defenses against hyper-natremia and hyperosmolality.
Hypernatremia is a ________ concentration greater than _____mEq/L.Because __________ is the primary electrolyte which affectsplasma osmolality, an elevated sodium concentration alwayscauses an elevated ________.The normal defenses against hypernatremia are ADH and______.
Although reviewed briefly in this chapter, the effects of, and the defenses against, hyperos-molality are discussed in detail in Chapter 5,
. An understanding of the nor-mal defenses against hyperosmolality is important to understand the development of hyper-natremia.