Issues in the nursing management of patients with water intoxication

The syndrome of water intoxication, experienced by a small percentage of hospitalized chronically mentally ill patients, is a two-stage process, usually beginning with polydipsia. In some patients the physiological ability to excrete excess free water is lost, and polydipsia progresses to hypervolemia and hyponatremia. The hyponatremia responds to fluid restriction. Nevertheless, nursing intervention associated with limiting a patient's fluids is complex, including psychodynamic, social, and behavioral factors. Because of the complexity of nursing care, and because of the unanswered questions about etiology and treatment of water intoxication, the area is fertile for nursing research.