NURSING MANAGEMENT

• Accurately measure and record intake and output

• Assess skin turgor at least every 8 hours for signs of dehydration
• Restrict fluid intake as ordered (fluid restriction is the primary treatment for
dilutional hyponatremia
• Administer Oral sodium supplements as ordered
• Provide a safe environment for patients with altered thought processes
• Seizure precautions
HYPERNATREMIA
 HYPERNATREMIA

• Hypernatremia, less common problem than hyponatremia

• Refers to excess of sodium relative to the amount of water

in the body
• Sodium is above normal >145 mEq/L

• Could caused by “losing more water than sodium or

gaining more sodium than water”
 Hypernatremia
> 145 mEq/L
Intracellular Extracellular

Pathophysiology:

The cells play a role in maintaining sodium

balance. When serum osmolality increases
because of hypernatremia, fluid moves by osmosis
from inside the cell to outside the cell. As fluid
leaves the cell, they become dehydrated and
shrink.
Risk factors Signs and Symptoms

• Dehydration
• Age
• Polydipsia
• Impaired thirst sensation • Restless
• Dry mouth & Skin
• Insufficient fluid intake
• Fever
• Impaired ability to express thirst,
• Central Diabetes insipidus
• Nephrogenic Diabetes insipidus
• Vasopressin (AVP) deficiency 
• Sodium gain