Nursing Implementation
The goal of treatment in hypernatremia is to treat the underlying
cause. In primary water defi cit, the continued water loss must be
prevented and water replacement must be provided. If oral fl uids
cannot be ingested, intravenous solutions of 5% dextrose in water
or hypotonic saline may be given initially. Serum sodium levels
must be reduced gradually to prevent too rapid a shift of water
back into the cells. Overly rapid correction of hypernatremia can
result in cerebral edema. The risk is greatest in the patient who has
developed hypernatremia over several days or longer.
The goal of treatment for sodium excess is to dilute the sodium
concentration with sodium-free IV fl uids, such as 5% dextrose in
water, and to promote excretion of the excess sodium by administering
diuretics. Dietary sodium intake will also be restricted. (See
Chapter 50 for specifi c treatment of diabetes insipidus.)