12th April 2024

A 73 year old female has been admitted to hospital after presenting with reduced appetite and fatigue.

A 73 year old female has been admitted to hospital after presenting with reduced appetite and fatigue. She is currently undertaking her 4th cycle of cisplatin based therapy for a liver carcinoma. She lives alone but has the community nurse visiting her regularly. Admission bloods reveal a sodium of 121 (135 – 145 mmol/L). She appeared dehydrated and the team gave IV fluids. The next day she becomes confused wandering around the ward reporting that she sees animals. Repeat sodium shows a level of 131. On examination, she has normal power, reduced sensations in her lower limbs and normal reflexes, including downgoing plantars. What is the most likely explanation for her confusion?

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