Hyponatremia with sodium greater than 125 mEq/L is typically treated with which measure?

• A. Hypertonic saline
• B. Demerol
• C. 3% saline
• D. Water restriction

Answer: (D)

Managing mild hyponatremia—where the sodium is greater than about 125 mEq/L and there are no or only mild symptoms—focuses on reducing free water intake. Water restriction directly addresses the underlying problem: excess water diluting the serum sodium. By limiting intake, sodium concentration can rise gradually as the kidneys excrete dilute urine, avoiding rapid shifts that could harm the brain. Hypertonic saline or 3% saline is reserved for severe, life-threatening neurologic symptoms and can risk overcorrection in milder cases. Demerol has no role in correcting sodium abnormalities. After starting fluid restriction, identify and treat any underlying cause (such as SIADH, hypothyroidism, or adrenal insufficiency) and monitor the correction rate to prevent overshoot.