26th January 2024

An 81-year-old male from a residential home was admitted to the elderly care ward with a fractured distal radius after sustaining a fall whilst going to the toilet.

An 81-year-old male from a residential home was admitted to the elderly care ward with a fractured distal radius after sustaining a fall whilst going to the toilet. He has a history of mild dementia and previous humeral fracture. His BMI is 18 kg/m². He does not drink any alcohol, but has a 40-pack-year smoking history. He attended fracture clinic after discharge, and some routine bloods were taken:

Hb 132 g/L (130-180)

MCV 94 (80-96)

WCC 8.0 x 10⁹/L (4.0-11.0)

CRP 5 mg/L (<10)

Sodium 134 (133–146 mmol/L)

Potassium 4.0 (3.5–5.3 mmol/L)

Creatinine 80 (45–84 μmol/ L)

EGFR >90 

Serum adjusted calcium level 2.1 (2.2-2.6 mmol/L)

Serum phosphate level 0.75 (0.74 – 1.4 mmol/L)

Serum albumin 37 (35–50 g/L)

Vitamin D 15 : (> 500 nmol/L)

What is the next most appropriate step in the management of this man?

Select the SINGLE most appropriate option from the list below. Select ONE option only.