A 60 year old woman with past medical history of alcohol abu…
A 60 year old woman with past medical history of alcohol abuse and bipolar schizophrenia presents to the hospital after a fall complicated by numerous rib fractures seen on chest x-ray. She is currently not taking any medications. On physical examination, her temperature is 37.1°C, BP 138/88 mm Hg, HR 99, RR 14, and oxygen saturation is 95% on room air. Her neurological, cardiovascular, and abdominal examinations are normal. She exhibits tenderness to palpation over the left chest wall with decreased bibasilar breath sounds. Her chemistry panel is as follows:Sodium 122 mEq/L (mmol/L), Potassium 2.8 mEq/L (mmol/L)BUN 5 mg/dL, Creatinine 0.7 mg/dLUrine osmolality 117 mOsm/kg, Urine sodium 18 mEq/L (mmol/L), Serum osmolality 266 mOsm/kgGlucose 105 mg/dLThyroid stimulating hormone 2.20 mIU/LMorning cortisol 16 µg/dLTotal cholesterol 140 mg/dL, HDL cholesterol 55 mg/dL, LDL cholesterol 124 mg/dL, Triglycerides 162 mg/dLWhat is the MOST appropriate management of her hyponatremia?