Hyponatremia with Severe Symptoms - Management Algorithm with Hypertonic Saline The goal of acute management is to raise the Na by 5 or stop the symptoms, whichever is quicker. If you have raised the Na by 5 and they are still seizing, then it is probably not the low Na causing the seizure and you need to look deeper. - Joel M. Topf, MD FACP @kidney_boy #Hyponatremia #Severe #Management #Algorithm #treatment #Hypertonic #Saline #nephrology