Question

A 70-year-old woman presents with hyponatraemia (serum sodium 120 mmol/L) detected on routine bloods. She is asymptomatic, euvolaemic on examination and takes a thiazide diuretic and an SSRI. Serum osmolality is low. What is the most appropriate first management step?

Accepted Answer

Stop possible offending medications such as thiazide and SSRI and restrict fluid intake

Answer

Rapidly correct sodium with hypertonic saline to normal within 6 hours

Answer

Give normal saline bolus regardless of volume status

Answer

Start demeclocycline immediately

Answer

No action is needed as she is asymptomatic

Practice question

A 70-year-old woman presents with hyponatraemia (serum sodium 120 mmol/L) detected on routine bloods. She is asymptomatic, euvolaemic on examination and takes a thiazide diuretic and an SSRI. Serum osmolality is low. What is the most appropriate first management step?