endocrine and metabolic disorders
Hypernatremia
Symptoms and Signs of Hypernatremia
The major symptom of hypernatremia is thirst. The absence of thirst in conscious patients with hypernatremia suggests an impaired thirst mechanism. Patients with difficulty communicating or ambulating may be unable to express thirst or obtain access to water. Patients with difficulty communicating may express thirst by becoming agitated. The major signs of hypernatremia result from central nervous system (CNS) dysfunction due to brain cell shrinkage. Confusion, neuromuscular excitability, hyperreflexia, seizures, or coma may result. Cerebrovascular damage with subcortical or subarachnoid hemorrhage and venous thromboses have been described in children who died of severe hypernatremia. In chronic hypernatremia, osmotically active substances are generated in CNS cells (idiogenic osmoles) and increase intracellular osmolality. Therefore, the degree of brain cell dehydration and resultant CNS symptoms are less severe in chronic than in acute hypernatremia. When hypernatremia occurs with abnormal total body sodium, the typical symptoms of Volume Depletion or 