Hypernatremia physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Feham Tariq, MD [2]

Overview

Patients with hypernatremia appear lethargic, weak and confused. However, the physical examination findings are related to the amount of volume deificit in the body and neuronal shrinkage as a result of hypertonicity. For the physical exam findings to become apparent, acute elevation in the serum sodium concentration to above 158 mEq/L is required.

Hypernatremia physical examination

Patients with hypernatremia appear lethargic, weak and confused. However, the physical examination findings are related to the amount of volume deificit in the body and neuronal shrinkage as a result of hypertonicity. For the physical exam findings to become apparent, acute elevation in the serum sodium concentration to above 158 mEq/L is required.

Appearance of the Patient

  • Patients with hypernatremia appear lethargic, weak and confused. However, the physical examination findings are related to the amount of volume deificit in the body and neuronal shrinkage as a result of hypertonicity.

Vital Signs

The vital signs in hypernatremia are as follows:[1][2]

  • Orthostatic blood pressure changes
  • Tachycardia

Skin

  • Skin examination of patients with hypernatremia is positive for:[3]
    • Abnormal skin turgor
    • Dry axillae

References

  1. Sterns RH (2015). "Disorders of plasma sodium--causes, consequences, and correction". N Engl J Med. 372 (1): 55–65. doi:10.1056/NEJMra1404489. PMID 25551526.
  2. McManus ML, Churchwell KB, Strange K (1995). "Regulation of cell volume in health and disease". N Engl J Med. 333 (19): 1260–6. doi:10.1056/NEJM199511093331906. PMID 7566004.
  3. Moder KG, Hurley DL (1990). "Fatal hypernatremia from exogenous salt intake: report of a case and review of the literature". Mayo Clin Proc. 65 (12): 1587–94. PMID 2255221.

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