BOF:
140
A 72
year old male was admitted with a history of agitation and confusion. He was
known to have ischaemic heart disease and diet controlled diabetes. He was on
aspirin and atenolol. He had been recently commenced on citalopram by his GP
for anxiety and depression. He did not smoke or drink. He was married and
lived with his wife and to the point of admission had been independent in his
activities of daily living.
On
examination there was no oedema, he looked well hydrated, his pulse rate was
60 beats per minute regular BP 140/80 heart sounds were normal, no murmurs,
lungs were clear. Apart from being confused and not oriented well in time
place and person there were no neurological abnormalities.
Investigations
Hb
13.2 g/dL
WBC
7.8 x109/L
Sodium 115 mmol/L
Potassium 3.5 mmol/L
Urea
7.2 mmol/L
Glucose 6.3 mmol/L
Urinary sodium 85 mmol/L
In
this patient what would be your next course of action?
a)
Fluid restriction
b)
Infuse sodium chloride
c)
Treat with demeclocycline
d)
Discontinue atenolol
e)
Discontinue citalopram
