{"id":1277,"date":"2017-06-16T06:42:51","date_gmt":"2017-06-16T06:42:51","guid":{"rendered":"http:\/\/papergp.com\/index.php\/data-interpretation\/ues\/hypernatraemia\/"},"modified":"2023-01-24T11:25:25","modified_gmt":"2023-01-24T11:25:25","slug":"hypernatraemia","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/data-interpretation\/ues\/hypernatraemia\/","title":{"rendered":"Hypernatraemia"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4>Background<\/h4>\n<ul>\n<li>Usually due to dehydration rather than excess of sodium<\/li>\n<li>Symptoms\n<ul>\n<li>Headache, confusion, n&amp;v<\/li>\n<li>lethargy, seizures, LOC<\/li>\n<li>nystagmus, myoclonic jerks, postural hypotension<\/li>\n<\/ul>\n<\/li>\n<li>Risk factors\n<ul>\n<li>Age &gt; 65<\/li>\n<li>Dementia, mental or physical disability<\/li>\n<li>Residential care<\/li>\n<\/ul>\n<\/li>\n<li>Causes\n<ul>\n<li>Low fluid intake<\/li>\n<li>Diabetes insipidus\n<ul>\n<li>central (lack of pituitary ADH secretion) vs nephrogenic (renal resistance to ADH)<\/li>\n<li>polyuria, polydipsia,<\/li>\n<li>causes of nephrogenic &#8211; lithium<\/li>\n<li>causes of central &#8211; head injury, pituitary disease<\/li>\n<\/ul>\n<\/li>\n<li>Hyperosmolar Hyperglycaemic State (HHS\/HONK)\n<ul>\n<li>Severe prolonged hyperglycaemia causing osmotic diuresis<\/li>\n<\/ul>\n<\/li>\n<li>Others &#8211; Cushing&#8217;s, Conn&#8217;s<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Data gathering<\/h4>\n<ul>\n<li>Hx &#8211; polyuria, polydipsia, thirst, medications<\/li>\n<li>Examine &#8211; neuro, L\/S BP, volume status<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Clinical Management<\/h4>\n<ul>\n<li>Investigations\n<ul>\n<li>Bloods &#8211; FBC, U+E, glucose, osmolality, urine Na and osmolality<\/li>\n<li>(urine osmolality &#8211; if dehydrated, urine will be concentrated i.e. osmolality &gt; 750mmol\/kg &#8211; if inappropriately dilute, consider diabetes insipidus)<\/li>\n<\/ul>\n<\/li>\n<li>Treatment\n<ul>\n<li>Treat cause &#8211; likely rehydration, daily review\/U+E testing, avoid rapid reduction (to avoid acute cerebral oedema)<\/li>\n<\/ul>\n<\/li>\n<li>Safety-net \/ Follow-up\n<ul>\n<li>Admit if\n<ul>\n<li>Na &gt; 155 mmol\/L<\/li>\n<li>Na 146-155 with neurological disturbance\/inability to drink adequately<\/li>\n<li>HHS i.e. hypernatraemia plus hyperglycaemia<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background Usually due to dehydration rather than excess of sodium Symptoms Headache, confusion, n&amp;v lethargy, seizures, LOC nystagmus, myoclonic jerks, postural hypotension Risk factors Age &gt; 65 Dementia, mental or physical disability Residential care Causes Low fluid intake Diabetes insipidus central (lack of pituitary ADH secretion) vs nephrogenic (renal resistance to ADH) polyuria, polydipsia, causes &hellip; <a href=\"https:\/\/papergp.com\/index.php\/data-interpretation\/ues\/hypernatraemia\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Hypernatraemia<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":1269,"menu_order":16,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1277","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1277","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=1277"}],"version-history":[{"count":5,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1277\/revisions"}],"predecessor-version":[{"id":1880,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1277\/revisions\/1880"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1269"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=1277"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}