What is the treatment for normovolemic hypernatremia?

In the case of normovolemic hypernatremia, the primary goal is to lower the sodium concentration in the blood while maintaining overall fluid balance. The correct treatment involves the administration of 5% dextrose in water. This solution provides free water without the excess sodium that normal saline contains, which is vital in this scenario where the sodium levels are already elevated.

When treating hypernatremia, it’s essential to provide free water to help dilute the serum sodium concentration. Normal saline would not be appropriate because it contains sodium chloride, which could exacerbate the hypernatremia rather than alleviate it.

5% dextrose in water effectively corrects the hypernatremia as it becomes metabolized, providing free water to the body and promoting osmotic balance without adding more sodium. Oral rehydration is less effective in severe cases of hypernatremia or when the patient is unable to ingest fluids adequately. Intravenous potassium chloride is not relevant for the treatment of hypernatremia and is specifically used to correct potassium deficiencies.

Thus, using a solution that introduces free water, like 5% dextrose in water, is the optimal approach to safely manage normovolemic hypernatremia.