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Usually the hypernatraemic patient is hypovolaemic, we can calculate

the water deficit by the equation:

Water deficit (litre)=Plasma Na
140
−1x (0.6 Xbody weight)

For example, a patient of 60 kg with plasma sodium 160 mmol/L, his

water deficit is 5.1 litre.

The water deficit could be given orally as water or intravenous as 5%

dextrose in water. If there is Na+ loss as well give D 5%/1/2 saline

(glucose 5% in half tonic saline) is given.

Rarely the hypernatraemic patient is hypervolaemic, in this situation

we have to give furosemide (lasix) and compensate urine loss with

either oral water or D 5% I.V.

2- Treatment of the etiologic cause as DDAVP intranasally for CDI.

III. DISTURBANCES IN PLASMA POTASSIUM

CONCENTRATION

Most of body K+ is intracellular. The intracellular K+ is about 150

mmol/litre, while plasma K+ is only 3.5-5.5 mmol/litre. The capacity of

the kidney to excrete K+ load is large but relatively slow (> 30 min). The

shift between intra- and extracellular compartments is quick and fast.

Hyperkalaemia

It is plasma K+ concentration which is more than 5.5 mmol/litre.

Causes of hyperkalaemia:

These could be summarized as the following: