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 ?😕😕:
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Step II Th of hypernatremia
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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.
Bring it down slow to avoid central pontine myelinolysis, Calculate the free water deficit and replace that over days.
