Hyper Nat Re Mia

HYPERNATREMIA Presented By: Group II: Balaba, Ceria Raym T. Cabarles, Ma. Antonette C. Casas, Joann T. Gialolo, Jennifer C. Ollosa, Ami A. Obaredes, Mark Grason L.

What is HYPERNATREMIA ? •

•A

plasma sodium level greater than 145meq/L. • Sodium excess in the blood. 

Who are prone to it? • Common on older adults and debilitated people, who may not recognize that they are thirsty or unable to get themselves to drink. • It also occur in people to take diuretics which cause the kidney to excrete. • Those with diabetes insipidusor diseases of hypothalamus of the pituitary gland.

What are the causes?          •

Inadequate water intake with decrease thirst. Excessive or rapid IV administration of normal saline solution. Kidney disease GI or skin problems. Vomiting Diarrhea Polyuria NPO status High salt intake.

What are the symptoms? Dry, sticky mucus membrane  Flushed skin  Rough and dry tongue.  Oliguria – anuria  Firm skin turgor  Edema  Intense thirst 

•

Contributing Conditions 





Hypovolemia hypernatremia  Renal losses, diuretics  Profuse diaphoresis, decreased thirst, burns, diarrhea. Euvolemic hypernatremia  Excess fluid losses from skin and lungs, diabetes insipidus Hypovolemic hypernatremia  Administration of concentrated saline solution  Hypertonic feedings

Diagnostic Findings Plasma Na level- more than 145 meq/L.  Plasma osmolality more than 295 meq/L.  Plasma Cl level more than 106 meq/L. 

Medical Management GOAL: • Correction of the body water osmolality, with restoration of cell volume, by decreasing the ratio of sodium to water to ECF. •

•

  

Hyperosmolar electrolyte solution. Diuretics Na restriction

Nursing Diagnosis  Hypernatremia

related to decrease thirst  Hypernatremia related to excessive administration of salt solutions.

Interventions 









Monitor clients for response to IVF replacement of hypotonic electrolyte solution, return to normal Na level. Maintain prescribed rate of IV, use IV pumps. Offer water and fluids hourly to clients with hypovolemic hypernatremia. Consult with dietician and physician regarding used for fluid and Na restriction. Teach client and family members.

Intense thirst

edema

Firm skin turgor

THANK YOU VERY MUCH !!! • • •

Have a nice day.. God bless..