The Merck Manual characterizes a high sodium level, or hypernatremia, as too much sodium in the body in relation to the amount of water. Sodium is found in the blood and the fluid around the cells and is regulated by the kidneys. Sodium may increase to a high level when the amount of water excreted is excessive. The slow reduction of sodium is the goal of treatment, guided by serial sodium blood tests, to prevent permanent brain damage.
Controlled replacement of water loss is the focus for treatment with hypernatremia according to The Merck Manual. Initially treatment may require fluids be administered through the veins to better control the volume taken against the results of serial blood tests to monitor sodium response. The expectation is that sodium will slowly decrease with the administration of fluids. The types of fluids for intravenous replacement may include normal saline or five percent dextrose and water.
Diagnosing the causes of hypernatremia may prevent a future episode. Serious causes may include head trauma, according to the American Association of Critical Care Nurses. Additional causes include excessive loss of water through diarrhea, vomiting, fever and a disproportionate amount of exertion and sweating and restricted availability to water. Older individuals on diuretics, medications that increase the excretion of water, are singularly at risk for hypernatremia during hot weather or severe illness when water loss may exceed intake.
Appropriate amounts of water, juices and other fluids consumed during the course of a day may help to prevent high sodium levels. Offering fluids frequently to the elderly may help protect this particularly vulnerable group from the harm of hypernatremia. Hypernatremia may be life-threatening to the elderly because of undiagnosed underlying illnesses. Adequate fluids during times of illness and treatment for fever, diarrhea and vomiting may help prevent hypernatremia, according to the Penn State Hershey Medical Center.
Complications of severe hypernatremia are primarily related to brain dysfunction with symptoms of fatigue, restlessness and confusion. Elevated sodium levels cause a shift of water out of the cells and may result in cell dehydration and subsequent neurologic symptoms. Additional assessments may reveal disorientation, flushed skin, a low-grade fever, a dry, swollen tongue and mucous membranes that are sticky. Nervous system symptoms may progress to seizures, coma and potential neurologic damage without intervention.