In treating a patient with a sodium level of 115 who exhibits neuro signs and symptoms, what is the recommended treatment?

In managing a patient with severe hyponatremia, particularly when accompanied by neuro signs and symptoms, the priority is to correct the sodium level cautiously to prevent potential complications such as osmotic demyelination syndrome. The administration of hypertonic saline, specifically 3% sodium chloride (NS), is a standard treatment approach in this scenario.

Hypertonic saline is used because it has a higher concentration of sodium compared to plasma, allowing for a more targeted and efficient increase in serum sodium levels. When this solution is given, it helps to rapidly correct the low sodium levels and alleviate neurological symptoms related to the hyponatremia, such as confusion, seizures, or even coma. The infusion of loop diuretics may also be considered in certain cases to prevent fluid overload, especially if fluid retention is a concern.

Other options, such as normal saline or half normal saline, are not appropriate for severe hyponatremia with neurological symptoms. Normal saline would not provide an adequate increase in sodium levels, and half normal saline would further dilute the sodium, worsening the condition. D5W contains no sodium and would exacerbate the low sodium levels. Therefore, the use of 3% NS not only corrects sodium levels effectively but does