Certified Emergency Nurse (CEN) Practice Test

What is the consequence of correcting hyponatremia too rapidly?

1. Heart attack

2. Seizures

3. Central pontine myelinolysis

4. Heart failure

The correct answer is: Central pontine myelinolysis

Correcting hyponatremia too rapidly can lead to central pontine myelinolysis (CPM), also known as osmotic demyelination syndrome. This condition arises when the serum sodium levels are increased too quickly, typically by more than 12 mEq/L in a 24-hour period. The rapid correction causes a shift of water out of brain cells, leading to severe damage. CPM primarily affects areas of the brain known as myelin sheaths, particularly in the pons, and can result in serious neurological symptoms such as paralysis, dysphagia, and altered mental status. It is essential for healthcare providers to carefully manage the rate of sodium correction in patients with hyponatremia to avoid this potentially devastating complication. Monitoring and adjusting serum sodium levels gradually, under appropriate clinical guidelines, are critical to preventing CPM and ensuring patient safety.