22nd May 2025

You are asked to review a patient on the medical ward who is feeling nauseated.

You are asked to review a patient on the medical ward who is feeling nauseated. They were admitted to hospital today with a community acquired pneumonia requiring low level oxygen therapy. They have no significant past medical history and take occasional gaviscon for reflux symptoms. On review, they have dry mucus membranes, and report that their urine is a little dark in colour. Observations are RR 21, SpO2 96% on 4 litres oxygen, BP 111/74, HR 96, temp 37.2 C. Their bloods show: 

WBC: 15.1 

Hb: 124

Plt: 478

Na+: 129

K+: 3.6

Urea: 9.2

Creat: 101 (at baseline) 

What is the next best step in management in terms of their hyponatraemia? Please select only ONE answer.