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Pediatrics Nutrition 061900ac

The initial fluid of choice of the treatment of hypernatremic dehydration is

A
Normal saline
B
N/2 saline
C
N/4 saline
D
D/4 saline + 5% Dextrose
High-Yield Explanation
The initial resuscitation of hypernatremic dehydration requires restoration of the intravascular volume with NS. RL and other fluids should not be used because they are hypotonic fluids.Seizures are the most common manifestation of cerebral edema from an overly rapid decrease of the serum sodium concentration during correction of hypernatremic dehydration. Signs of increased intracranial pressure or impending herniation may develop quite rapidly (see Chapter 68). Acutely, increasing the serum concentration an infusion of 3% sodium chloride can reverse the cerebral edema. Each 1 mL/kg of 3% sodium chloride increases the serum sodium concentration by approximately 1 mEq/L. An infusion of 4 mL/kg often results in resolution of the symptoms. This strategy is similar to that used for treating symptomatic hyponatremia Ref.nelson 20th edition 390 page

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