Laboratory Data

1. Serum electrolytes. Serum sodium concentration > 146 mEq/L is abnormal. Monitor serum electrolytes for hypokalemia and hypercalcemia, which are possible etiologies of hypernatrem-ia. Look for hypocalcemia as a sequela of hypernatremia. Follow serum sodium concentration closely.

2. Renal studies. Elevated BUN and creatinine may suggest intrinsic renal disease. If the BUN-to-creatinine ratio is > 20:1, dehydration is present; when the ratio is < 10:1, intrinsic renal disease is present.

3. Serum glucose. Mild hyperglycemia is often noted in hypernatremia. Etiology of elevated serum glucose is unknown.

4. Urine osmolality. Value > 700 mOsm/kg-H2O suggests that child's renal concentrating capacity is intact, eliminating diabetes insipidus as a cause of hypernatremia.

5. Spot urine sodium. In the presence of hypernatremia, spot urine sodium < 10 mEq/L suggests extrarenal losses of sodium.

6. Water deprivation test. Performed in stable, well-hydrated patients. Serum sodium concentration and osmolality, urine specific gravity and osmolality, and weight are monitored every 2 hours. Patient is water deprived until one of the following occurs: loss of more than 3% of body weight; or serum sodium concentration > 150 mEq/L and serum osmolality > 300 mOsm/kg-H2O. Patients with central or nephrogenic diabetes insipidus develop serum sodium concentrations > 150 mEq/L in the face of urine osmolality < 150 mOsm/kg-H2O and weight loss of 3% or more. Patients with central diabetes insipidus respond to DDAVP or vasopressin by increasing their urine osmolality and decreasing urine volume.

Diabetes Sustenance

Diabetes Sustenance

Get All The Support And Guidance You Need To Be A Success At Dealing With Diabetes The Healthy Way. This Book Is One Of The Most Valuable Resources In The World When It Comes To Learning How Nutritional Supplements Can Control Sugar Levels.

Get My Free Ebook

Post a comment