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In hypernatremic dehydration, there is a greater loss of water than sodium. The key to the treatment of hypernatremia is slow correction of the serum sodium concentration. If the serum sodium falls too quickly, free water will move from the serum into the relatively hypertonic brain tissue, causing cerebral edema. hypernatremic dehydration involves fluid therapy calculated over at least 48 hours. The goal is to avoid dropping the sodium any faster than 2.5 mEq per four hours. Calculate the water deficit.Replete water and electrolytes over 2 to 3 days. water deficit = 0.6 x body weight (kg) x (1-140/serum Na) In moderate hypernatremia (serum Na between 155 and 175), one half of the free water deficit is given in the first 24 hours. In severe hypernatremia (serum Na greater than 175), one third is given in the first 24 hours. Electrolyte-free solutions are never given, at a minimum, use 0.2% NS.
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