A 76-year-old woman started hydrochlorothiazide 3 weeks ago. She has mild fatigue but is alert. Sodium is 126 mEq/L, serum osmolality is low, and

Question

A 76-year-old woman started hydrochlorothiazide 3 weeks ago. She has mild fatigue but is alert. Sodium is 126 mEq/L, serum osmolality is low, and urine sodium is elevated. She has no seizures or severe symptoms. Which of the following is the most appropriate at this time?

Accepted Answer

Stop hydrochlorothiazide and correct sodium gradually

Answer

Encourage excessive free water intake

Answer

Start desmopressin as sole therapy

Answer

Give rapid hypertonic saline to normal sodium

Answer

Continue thiazide and repeat labs in 1 year

Chronic hyponatremia thiazide — USMLE Step 3 MCQ

A 76-year-old woman started hydrochlorothiazide 3 weeks ago. She has mild fatigue but is alert. Sodium is 126 mEq/L, serum osmolality is low, and urine sodium is elevated. She has no seizures or severe symptoms. Which of the following is the most appropriate at this time?