A 63-year-old white man with a history of schizophrenia plus polysubstance and alcohol abuse was seen by his primary care physician during a routine visit, at which time he was found to have a serum sodium concentration of 113 mmol/L.
Student Discussion Document (pdf)
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A 63-year-old white man with a history of schizophrenia plus polysubstance and alcohol abuse was seen by his primary care physician during a routine visit, at which time he was found to have a serum sodium concentration of 113 mmol/L. The patient was contacted
by phone and advised to return to Urgent Care for assessment, but he did not respond until 7 days later, at which time his serum sodium concentration was 106 mmol/L. He reported that he felt fine the day before but that he started feeling very lethargic that morning and had trouble “keeping his eyes open.” The patient was noted to be somnolent and confused. Table 1 summarizes the patient’s laboratory data on admission.
Questions to Consider
- What are the causes of severe hyponatremia?
- How much water needs to be consumed before hyponatremia can occur in a patient with a
- In correcting severe hyponatremia, why must serum sodium be monitored closely?
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