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A 60-year-old patient presents with confusion and seizures. Labs show Na⁺ = 120 mEq/L. What is the most appropriate immediate therapy?
Question

A 60-year-old patient presents with confusion and seizures. Labs show Na⁺ = 120 mEq/L. What is the most appropriate immediate therapy?

A.

Oral salt tablets

B.

0.9% Normal saline infusion

C.

3% hypertonic saline infusion

D.

Fluid restriction only

Correct option is C

Severe symptomatic hyponatremia (<120 mEq/L) requires 3% hypertonic saline to prevent cerebral edema and seizures.
Explanation of options: (a) ✘ Oral salt tabs too slow, not for acute symptomatic cases. (b) ✘ NS is for mild-moderate cases; here hypertonic saline needed. (c) ✔ Correct; 3% NS is treatment for severe symptomatic hyponatremia. (d) ✘ Fluid restriction is for chronic/mild cases.

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