48 year old woman, presented with increasing confusion over the last 3 days. This woman received her first dose of chemotherapy for cervical cancer 5 days ago. At that time her blood tests were within normal ranges. 10 minutes after arrival she developed tonic clonic seizure that was terminated with a single dose of midazolam.

Her VBG showed the following

PH = 7.26

PCO2 = 48  mmHg

PO2 = 52 mmHg

HCO3 = 21 mmol/L

Na = 121 mmol/L

K = 4.1 mmol/L

Cl = 84 mmol/L

Cr = 76 nmol/L

Glucose = 9.5 mmol/L

Lactate = 7.1 mmo;/L

Questions:

1. Interpret these results
2.  What are the consideration for the management of hyponatraemia?
3. How will you manage this case?