A 68-year-old woman on thiazide diuretic presents with nausea and confusion. Serum sodium is 118 mmol/L, serum osmolality is low, and she is euvolaemi...

Question

A 68-year-old woman on thiazide diuretic presents with nausea and confusion. Serum sodium is 118 mmol/L, serum osmolality is low, and she is euvolaemic. What is the most appropriate initial management in hospital?

Accepted Answer

Stop thiazide and restrict free water intake

Answer

Rapid correction with hypertonic saline to normal within a few hours

Answer

Give large volumes of normal saline regardless of volume status

Answer

No treatment is needed for asymptomatic hyponatraemia

Answer

Start demeclocycline immediately

ca-mccqe1 MCQ (SBA): Hyponatraemia

A 68-year-old woman on thiazide diuretic presents with nausea and confusion. Serum sodium is 118 mmol/L, serum osmolality is low, and she is euvolaemic. What is the most appropriate initial management in hospital?