21st May 2025

You are the on-call SHO in a busy district general hospital.

You are the on-call SHO in a busy district general hospital. You are asked to review a frail 75-year-old lady by the FY1 as she has a worsening hyponatraemia of 126 mmol/L today and reduced appetite. Yesterday the serum sodium was 129 mmol/L and has been trending down for the past 3 days. She was admitted one week ago for a community acquired pneumonia and has been treated with antibiotics. On assessment this lady is clinically well and reports no neurological symptoms but does have dry mucous membranes. Serum osmolality is 260 mOsmol/kg. Urine sodium is 14 mmol/L.

What is the most appropriate management for this lady from the options below? Please select only ONE answer.