Intermediate Care

Sodium

 

Hypernatraemia

Hypernatraemia is rare but has a high mortality rate (>50%). Management advice is available here.

If Na+>145 seek expert advice.

 

 

Hyponatraemia

 

ADMIT if

Na <115 mmol/L (severe hyponatraemia)

 

OR patient is symptomatic:

• Early symptoms

  • Anorexia.

  • Nausea.

  • Lethargy and apathy (associated with slow-onset hyponatraemia).

• Late symptoms (associated with severe or rapid-onset hyponatraemia).

  • Disorientation.

  • Agitation.

  • Seizures.

  • Coma.

 

OR patient has signs of hypovolaemia.

 

 

If Na is in the range 115-124 and the patient is asymptomatic, then seek advice from an endocrinologist, nephrologist, or clinical pathologist regarding admission to hospital or an urgent referral.

 

For Na >124 see GP Notebook guide.