Th of hypernatremia

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BlackAces

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Ok, totally lost, when do you use normal saline, D5W, 0.45% saline? So, according to UW, use normal saline for sever hypernatremia, initial resusc. in DKA, etc, then you can switch D5W. Kaplan Qbank, got a Q, pt has Na 163, what do you - D5W, reason ? - need to give hypotonic solution to correct the hypernatremia. Wait - if you give hypotonic solution in severe hypernatremia, there is a risk for cerebral edema and seizures. So, how do you treat hypernatremia ?😕😕:
 
Ok, totally lost, when do you use normal saline, D5W, 0.45% saline? So, according to UW, use normal saline for sever hypernatremia, initial resusc. in DKA, etc, then you can switch D5W. Kaplan Qbank, got a Q, pt has Na 163, what do you - D5W, reason ? - need to give hypotonic solution to correct the hypernatremia. Wait - if you give hypotonic solution in severe hypernatremia, there is a risk for cerebral edema and seizures. So, how do you treat hypernatremia ?😕😕:

Nobody?
 
Use something isotonic like 0.9% saline to resuscitate people who are volume deplete (oldies who have laid in bed for a week without drinking etc) then use something hypotonic like 0.45% saline or 5% dextrose to bring the sodium down.

Bring it down slow to avoid central pontine myelinolysis, Calculate the free water deficit and replace that over days.
 
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