What monitoring protocols should be followed for a patient receiving treatment for hypernatraemia?

Monitoring protocols for a patient receiving treatment for hypernatraemia include:

• Measure plasma electrolyte concentrations every 4 to 6 hours during the first 24 hours of treatment, then adjust the frequency of monitoring based on the patient's response to treatment.
• Ensure that the rate of fall of plasma sodium does not exceed 12 mmol/l in a 24-hour period to avoid complications.
• Regularly assess fluid status and adjust intravenous fluid prescriptions accordingly, including consideration of changing to hypotonic fluids if hypernatraemia worsens or remains unchanged after initial treatment.
• Monitor clinical response closely, including signs of dehydration or fluid overload, and reassess fluid management plans if the patient is transferred to a different care setting.

These steps help safely correct hypernatraemia while minimizing risks associated with rapid sodium changes and fluid mismanagement.

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