The Hypernatremia mind map is very similar to the hyponatremia mind map, which is also an abnormal lab finding. A clinician can see elevated sodium levels on a metabolic panel, which can be drawn as a routine lab or drawn because of a clinical indication which may present as relevant and helpful information.
Very high serum sodium level can present as an urgent/emergent situation regardless of the underlying cause. If a patient has an altered mental status, acute management is warranted. Probable diagnoses are divided into three categories based upon volume status. If a patient is clinically hypovolemic, a clinician can consider all causes of dehydration as listed on the clinical mind map. In this case, urine osmolality is high assuming that the kidney function is intact.
In a euvolemic patient in whom urine osmolality is normal or relatively low, a clinician can consider endocrine causes such as central and nephrogenic diabetes insipidus. In a patient who appears to be hypervolemic, a clinician can consider additional diagnoses such as hyperaldosteronism and iatrogenic causes. In these cases, the urine sodium level can further help narrow the differential diagnosis. A clinician can conduct the additional diagnostic tests that are listed on the clinical mind map to arrive at the final diagnosis.