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7 Cards in this Set
- Front
- Back
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What sodium level defines Hypernatraemia ?
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> 150 mmol/L
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What are the 3 main groups of causes of Hypernatraemia ?
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1. Inadequate water intake
2. Excessive sodium intake 3. Loss of Water >> sodium |
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List the causes of inadequate water intake in Hypernatraemia.
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Typically associated with Elderly / Disabled patients **
1. Unable to obtain 2. Impaired thirst 3. Dysphagia 4. Insensible losses |
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List the main causes of excessive sodium intake in Hypernatraemia.
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1. Iatrogenic
a. Hypertonic saline b. Sodium bicarbonate c. Lithium 2. Accidental ingestion ( sea-water drowning ; salt ) 3. Excess Mineralocorticoid /Glucocorticoid - Cushing's |
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List the main causes of Water loss greater than sodium in hypernatraemia.
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1. Gastrointestinal
a. Vomiting b. Diarrhoea c. Fistula 2. Renal ( Impaired concentrating ability ) a. Diabetes Insipidus b. Osmotic diuresis ( DKA) c. Hypercalcaemia 3. Skin losses a. Sweat ( heat stroke ) b. Burns |
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List the causes of Diabetes insipidus.
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Central Diabetes Insipidus
1. Idiopathic 2. Tumour 3. Trauma Nephrogenic Diabetes Insipidus 1. Drugs (Lithium) 2. Renal impairment 3. Haematological disorders 4. Familial disorders. |
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What are the main Management features of Hypernatraemia ?
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- Replace deficit + maintenance + ongoing losses
- correct slowly over 24-48 hours - Aim for 0.5 -1.0 mmol / L /Hr decrease in sodium If Hypovolaemic : correct with NaCL IV and oral free water If Hypervolaemic: correct with D5W and frusemide |
