any pearls to treating dehydration hypernatremia?

[Painter1]

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i'm doing my IM month. already had a couple terminal cancer patients come in altered wiht no PO intake diagosed with dehydration hypernatremia. the different senoirs I have blindly dump fluids NS and check chems q4. is there a practical guideline out there? i've read through different texts with nothing more than: "correct at less than 0.5mEq per hour." anyone care to shine some insight into the treatment of this condition.

 

[USCDiver]

1)Make the diagnosis
2)Admit to medical service

 

[NinerNiner999]

After you diagnose, start NS, then do what Diver said

 

[MasterintuBater]

Option A
Start normal saline. Order Urine Sodium/Cr/Osmols. Calculate free water deficit. Calculate correction rate. Discuss plan with medicine. Admit to medicine.

Option B
Admit to medicine. See three other patients.