What are the clinical manifestations of hypernatremia?

• A. Fever (low grade), flushed skin; Restless (irritable); Increased fluid retention and BP; Edema; Decreased urine output
• B. Weight gain only
• C. Nosebleeds
• D. Slow pulse

Answer: (A)

Hypernatremia causes cellular dehydration from high extracellular osmolality, so the clinical picture centers on dehydration and CNS effects. The brain is sensitive to water loss, so restlessness or irritability can occur as neurons shrink. Reduced urine output fits with dehydration as the kidneys conserve water to restore volume. Classic signs of dehydration, like dry mucous membranes and skin turgor changes, may also be present.

Fever, edema, and higher blood pressure are not typical features of hypernatremia due to water deficit; edema and hypertension suggest fluid overload, and fever is not a direct manifestation of a high sodium state. Therefore, the combination that best reflects hypernatremia among the options is restlessness and decreased urine output.