Approach to hyponatremia Quiz: Ace Your Exams

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A 25-year-old man is brought to the emergency department after developing a headache, confusion, nausea and vomiting while running a marathon. The patient felt like he had to stop running at mile 22 and subsequently had two episodes of non-bilious, non-bloody emesis. His past medical history is unremarkable, and he does not take any medication. Temperature is 38.0 °C (100.4 °F), blood pressure is 111/70 mm Hg, pulse rate is 105/min, and respiratory rate is 18/min. The patient appears confused. Physical examination reveals significant perspiration. Initial laboratory evaluation shows a serum sodium  level of 117 mEq/L. Which of the following is the most appropriate management?  

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