Question: What are the treatment strategies for hypernatremia?
Background Information
Hypernatremia is a common electrolyte problem resulting from an extremely high concentration of sodium in the blood. Sodium constitutes one of the most useful elements in the body as it facilitates critical processes such as producing red blood cells and developing strong bones. However, too much serum sodium concentration can cause a decline in total body water leading to hypernatremia. The condition presents symptoms such as muscle weakness, extreme thirst, irritability, and seizures. In severe cases, patients may experience difficulties concentrating, losing consciousness, and lacking energy and enthusiasm. If untreated, the condition may progress to cause adverse health implications such as rapture of blood vessels in the brain, which can cause physical and cognitive incapacitation or even death.
Relevant Primary Literature
Hypernatremia can occur due to too much water loss from the body or too much sodium intake. A study by Seay et al. (2020) investigates factors that cause disorders of body tonicity, such as hypernatremia and hyponatremia. The study found that hypernatremia often results from a high concentration of sodium in the body resulting from a decline in water intake (Seay et al., 2020, p. 272). Risk factors may include events that cause a rapid loss of water from the body, such as watery diarrhea, vomiting, and fever (Seay et al., 2020, p. 272). Therefore, the condition may be managed by increasing fluid intake to reduce sodium concentration in the body. Patients with severe cases may be connected to an IV drip to facilitate a rapid restoration of healthy water levels in the body (Seay et al., 2020, p. 273). Another study by Chauhan et al. (2019) investigated factors that regulate the rate of correction of hypernatremia among critically ill patients. The study found that hypernatremia depends on behavioral, emotional, and physiological factors. According to the study, individuals with underlying health conditions such as poorly controlled diabetes, dementia, and kidney disease are at risk of experiencing recurrent hypernatremia, which worsens with psychological distress and poor health behaviors (Chauhan et al., 2019, p. 656). Therefore, treatment for hypernatremia could focus on alleviating a patient’s underlying health condition.
Potential Therapeutic Options
Based on findings from the primary literature, therapeutic interventions administered to patients with hypernatremia should focus on alleviating behavioral and health factors causing increased sodium concentration levels in the blood. Therefore, therapists need to assess a patient’s medical history and social background to identify behaviors or health conditions that might have caused rapid loss of water from the body or increased sodium intake. Patients depicting behaviors that could potentially cause a rapid increase in sodium concentration in the body should be informed about behavior changes that could help alleviate symptoms and prevent the recurrence of the condition in the future. Individuals with underlying health conditions associated with rapid loss of water from the body should be administered interventions to reduce the severity of their underlying conditions.
Optimal Drug Therapy
Optimal drug therapy for patients presenting with hypernatremia could include the administration of dextrose accompanied by patient education and follow-up. Dextrose helps to reduce serum sodium concentration, making it an effective medication for individuals with hypernatremia. By implementing behavior change, patients could also be informed about ways to reduce their serum sodium concentration. For example, the patient could be advised to take fluids more frequently to increase the amount of water in their bodies. Patient follow-up could help to assess the effectiveness of therapy and determine the need for further interventions based on the patient’s response to treatment.
References
Seay, N. W., Lehrich, R. W., & Greenberg, A. (2020). Diagnosis and management of disorders of body tonicity—Hyponatremia and hypernatremia: Core curriculum 2020. American Journal of Kidney Diseases, 75(2), 272-286. https://pubmed.ncbi.nlm.nih.gov/31606238/
Chauhan, K., Pattharanitima, P., Patel, N., Duffy, A., Saha, A., Chaudhary, K., Debnath, N., Vleck, T., Chan, L., Nadkami, G., & Coca, S. G. (2019). Rate of correction of hypernatremia and health outcomes in critically ill patients. Clinical Journal of the American Society of Nephrology, 14(5), 656-663. https://pubmed.ncbi.nlm.nih.gov/30948456/
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