Assessment mental status

NPO for confusion
Na check q4h (q1-2 if hypertonic saline for severe hyperNa)
Labs: urine sodium, urine potassium for tonicity


  1. Loss of Drive to Drink (mental status, sedation, intubation, NPO
  2. Hypotonic fluid losses (fever, inc. minute ventilation, D.I. diuretics

Correction factor is men: 0.6, women: 0.5, eElderly men: 0.5, eElderly women: 0.45

You can be giving a low salt fluid and the patient may still be persistently hypernatremic if the tonicity of the fluid given is more than the tonicity excreted by kidney (there is not enough water in the solution to excrete the solute and so it is pulled from TBW)



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Last Updated August 10, 2015