A 58-year-old man with heart failure and long-term thiazide diuretic use presents with fatigue and confusion. Serum sodium is 122 mmol/L, serum osmola...

Question

A 58-year-old man with heart failure and long-term thiazide diuretic use presents with fatigue and confusion. Serum sodium is 122 mmol/L, serum osmolality is low, urine osmolality is high and he appears volume depleted on examination. What is the most appropriate initial management of his hyponatraemia?

Accepted Answer

Isotonic saline to restore volume status

Answer

Fluid restriction alone

Answer

Hypertonic (3%) saline bolus

Answer

Stop all fluids and observe

Answer

Immediate vasopressin receptor antagonist

ca-mccqe1 MCQ (SBA): Hypovolaemic hyponatraemia management