Hypernatraemia (Table 85.1)

End

Check electrolytes, creatinine/eGFR and glucose, and urine/plasma osmolality

Rare: seen when sodium bicarbonate is given to treat metabolic acidosis or hyperkalaemia
Stop sodium bicarbonate infusion
Use loop diuretic (or dialysis) to remove excess sodium

IV glucose or
PO water until water deficit corrected
Give vasopressin if there is central diabetes insipidus

IV half-normal saline or
IV glucose or
PO water until water deficit corrected

IV saline until systolic
BP >110 mmHg

Volume status (Box 85.2)?

Hypovolaemia