27th May 2025

Ms Stone is a 65-year-old woman who presents with generalised malaise, abdominal pain, diarrhoea and vomiting, on a background of hypertension, type 1 diabetes and rheumatoid arthritis.

Ms Stone is a 65-year-old woman who presents with generalised malaise, abdominal pain, diarrhoea and vomiting, on a background of hypertension, type 1 diabetes and rheumatoid arthritis. Her observations are as follows: BP 101/67, HR 108 bpm, RR 12, SpO2 98% on room air and T 36.4. Her initial blood tests show anaemia (101 g/L), hyponatremia (127 mmol/L), hyperkalaemia (5.8 mmol/L) and hypoglycaemia (3.2 mmol/L). What is the most appropriate first step?

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