What is the primary treatment for hypernatremia?

• A. Infusion of normal saline
• B. Administration of D5W or hypotonic fluid
• C. Administration of bicarbonate
• D. Intravenous calcium gluconate

Answer: (B)

The primary treatment for hypernatremia is the administration of D5W (5% dextrose in water) or other hypotonic fluids. This approach is effective because hypernatremia involves a high concentration of sodium in the blood, often due to dehydration or a deficit in water intake rather than an excess of sodium.

When D5W is administered, it provides free water that helps to dilute the sodium concentration in the bloodstream. Unlike normal saline, which contains sodium and can exacerbate hypernatremia, hypotonic fluids allow for the gradual correction of sodium levels. This is essential to avoid rapid shifts in sodium that can lead to serious neurological complications, such as cerebral edema.

Therefore, using D5W or a similarly hypotonic fluid is critical in safely and effectively treating hypernatremia by restoring normal fluid balance and achieving a controlled reduction in serum sodium levels.