Question

A 72-year-old woman presents with confusion and nausea. She has been taking a thiazide diuretic. Serum sodium is 118 mmol/L, serum osmolality is low and she appears mildly confused but haemodynamically stable without seizures. What is the most appropriate initial management strategy?

Accepted Answer

Slow correction with hypertonic saline aiming to increase sodium by no more than 8-10 mmol/L in 24 hours

Answer

Rapid correction with 3% saline to normalise sodium within 6 hours

Answer

Fluid restriction is contraindicated

Answer

Administer demeclocycline immediately

Answer

Induce diuresis with loop diuretics only

Practice question

A 72-year-old woman presents with confusion and nausea. She has been taking a thiazide diuretic. Serum sodium is 118 mmol/L, serum osmolality is low and she appears mildly confused but haemodynamically stable without seizures. What is the most appropriate initial management strategy?