Question

A 51-year-old man presents with confusion. Serum sodium is 118 mmol/L. He is euvolaemic on examination, with no oedema or dehydration. He has a history of small cell lung cancer. There are no seizures and he is haemodynamically stable. What is the most appropriate initial management?

Accepted Answer

Fluid restriction and treatment of the underlying cause

Answer

Rapid correction with hypertonic saline to normalise sodium within 6 hours

Answer

High-dose loop diuretics

Answer

No treatment is needed for sodium above 115 mmol/L

Answer

Give oral Sodium chloride tablets only

Practice question

A 51-year-old man presents with confusion. Serum sodium is 118 mmol/L. He is euvolaemic on examination, with no oedema or dehydration. He has a history of small cell lung cancer. There are no seizures and he is haemodynamically stable. What is the most appropriate initial management?