Hypernatremia in Severe Dehydration

Pathophysiology and Clinical Signs

Infectious diarrhea causes significant fluid and electrolyte losses from the gastrointestinal tract, leading to hypernatremia when water replacement is inadequate, as recommended by the Infectious Diseases Society of America 2, 3
Dry mucous membranes are a classic sign of volume depletion following fluid and salt loss with diarrhea, according to the American Society for Nutrition 1, 4
Tachycardia indicates compensatory cardiovascular response to volume depletion, as stated by the American College of Nutrition 1, 5
Weakness is common in both volume depletion and hypernatremia, as noted by the Clinical Nutrition Society 4

Isotonic intravenous fluids should be administered immediately to treat severe dehydration with signs of shock or altered mental status, as recommended by the Infectious Diseases Society of America 2, 3
Intravenous rehydration should be continued until pulse, perfusion, and mental status normalize, according to the Clinical Infectious Diseases Society 3
Once stabilized, oral rehydration solution (ORS) can be used to replace ongoing losses, as suggested by the Infectious Diseases Society of America 2, 3
Young adults can typically compensate for longer periods than elderly patients, but severe dehydration can still lead to significant morbidity and mortality, as stated by the American Society for Nutrition 1