Overview
What is the pathophysiology of hypernatremia?
What is the prevalence of hypernatremia in the US?
What is the global prevalence of hypernatremia?
What are the mortality rates for hypernatremia?
What is the sexual predilection of hypernatremia?
Which patients are at highest risk for hypernatremia?
Presentation
Which clinical history findings are characteristic of hypernatremia?
Which physical findings are characteristic of hypernatremia?
What causes of hypovolemic hypernatremia?
What causes of hypervolemic hypernatremia?
What causes euvolemic hypernatremia?
Which conditions are associated with central diabetes insipidus (DI)-related hypernatremia?
Which conditions are associated with nephrogenic diabetes insipidus (DI)-related hypernatremia?
DDX
What are the differential diagnoses for Hypernatremia in Emergency Medicine?
Workup
What is the role of lab testing in the workup of hypernatremia?
What is the role of serum sodium measurement in the workup of hypernatremia?
What is the role of imaging studies in the workup of hypernatremia?
What is the role of water deprivation testing in the workup of hypernatremia?
What is the role of antidiuretic hormone (ADH) stimulation in the workup of hypernatremia?
Treatment
What is included in prehospital care for hypernatremia?
What is included in emergency department (ED) care for patients for hypernatremia?
How are fluid deficits calculated in the emergency department (ED) care for hypernatremia?
Which specialist consultations are beneficial to patients with hypernatremia?
Medications
Which medications are used in the treatment of hypernatremia?
Follow-up
What is included in inpatient care for hypernatremia?
When is patient transfer indicated for the treatment of hypernatremia?
How is hypernatremia prevented?
What are the possible complications of hypernatremia?
What is the prognosis of hypernatremia?
What is included in patient education about hypernatremia?
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Figure A: Normal cell. Figure B: Cell initially responds to extracellular hypertonicity through passive osmosis of water extracellularly, resulting in cell shrinkage. Figure C: Cell actively responds to extracellular hypertonicity and cell shrinkage in order to limit water loss through transport of organic osmolytes across the cell membrane, as well as through intracellular production of these osmolytes. Figure D: Rapid correction of extracellular hypertonicity results in passive movement of water molecules into the relatively hypertonic intracellular space, causing cellular swelling, damage, and ultimately death.