how the heck
What electrolyte is responsible for maintaining BP, blood volume, and pH balance?
sodium
What age group is at an increased risk for developing hypernatremia?
older adults
What are 2 nervous system changes that you would notice in someone with hypernatremia caused by fluid deficit?
altered mental status, short attention span, agitation, confusion, increased thirst
What is the normal range of sodium in the blood, including the units?
135-145 mEq/L
What member of the healthcare team could assist the nurse in teaching the patient about foods high in sodium?
dietician
List three foods that are high in sodium.
salted nuts, canned soup, cured meats, savory snacks, bread, salted butter, etc
Bob is a 75 year old patient with muscle weakness and confusion due to hypernatremia, which he is currently being treated for. What is the priority nursing intervention?
fall risk measures
What nervous system changes would you notice in someone with hypernatremia caused by fluid overload?
lethargy, comatose
What two body fluids could be tested for suspected hypernatremia?
blood & urine
What type of fluid would be administered to a patient with hypernatremia (hypertonic, isotonic, or hypotonic)?
isotonic; sometimes hypotonic
List 3 possible causes of hypernatremia.
kidney failure
Cushing's syndrome
excessive sodium intake
dehydration
diarrhea
diaphoresis
One risk factor for hypernatremia is impaired kidney function. Name two diseases that lead to impaired kidney function.
diabetes, hypertension, heart disease, severe UTIs, etc
What muscular changes would you see in a patient with developing hypernatremia?
muscle twitching at first, leading to progressive muscle weakness and decreased deep tendon reflexes
What is an example of a drug that a provider would prescribe for a patient with hypernatremia d/t fluid overload?
furosemide (Lasix)
After administering diuretics to a patient with hypernatremia d/t fluid overload, what does the nurse need to monitor for, and how often?
urine output; every hour
What is the correct term for the structural change that happens to cells when cellular dehydration occurs?
plasmolysis (shrinkage)
Name two substances that can cause kidney damage.
NSAIDs, illicit drugs (cocaine, heroin, amphetamines)
DASH describes common cues of hypernatremia. What does DASH stand for?
dehydrated, agitated, swollen, hot
What is an example of a fluid that a provider would prescribe for a patient with hypernatremia d/t fluid deficit?
0.9% NS
or
D5 in 0.45% NS
You are providing discharge teaching to a client who just finished treatment for hypernatremia d/t fluid deficit. What two things should you include in your teaching as you prepare them to go home?
drink 2-3 L of water daily to prevent dehydration
teach the patient how to read sodium labels on foods
Fluid _____ and fluid _____ in the body can both cause hypernatremia.
overload & deficit
Name 3 potential complications of untreated hypernatremia.
extreme dehydration, seizures, coma, death
While taking vitals, what cardiovascular changes would you find in someone with hypernatremia?
hypotension & tachycardia
What labs would be drawn to test for hypernatremia?
BMP & CMP
Name a specific part of the head-to-toe assessment that you would perform to assess for progressive changes in a patient with hypernatremia.
assess for bilateral muscle strength by having the patient squeeze your hands and push/pull with hands and feet