Case #4:

 

84 yo woman admitted through the emergency room from a nursing home where she resides due to advanced dementia. She was found to be more confused than her baseline. She is unable to feed herself and has g-tube in place. The SNF staff noted that the water supplementation along with tube feeds has been difficult due to the tube being clogged. Patientís admission tests showed a sodium of 152 meq/L.