8th July 2024

An 88-year-old man is referred by his GP with lethargy and shortness of breath. He is seen by the acute team

An 88-year-old man is referred by his GP with lethargy and shortness of breath. He is seen by the acute team who diagnose a community acquired pneumonia. He is normally a nursing home resident and has Alzheimer’s dementia. Bloods demonstrate a sodium of 155 mmol/L. His bloods were last checked 2 months ago and demonstrated a normal sodium. He was treated by the acute medical team with IV 0.9% saline. His observations demonstrated hypotension and tachycardia on admission, however they have normalised overnight. Bloods today demonstrated sodium of remains raised at 154 mmol/L. He remains delirious, with a GCS of 13.

What is the most appropriate management strategy?

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