A 66-Year-Old Hospitalized Man Is Evaluated After an Episode of Generalized

A 66-year-old hospitalized man is evaluated after an episode of generalized tonic-clonic seizure.  The patient has no previous history of seizure.  He underwent right hemicolectomy for cecal adenocarcinoma the previous day.  Postoperatively, the patient had hypotensive episodes, which responded to fluid resuscitation.  He has been receiving intravenous infusion of 5% dextrose with 0.45% saline.  He is also receiving morphine via a patient-controlled device.  On physical examination, he is postictal.  Temperature is 36.7 C (98 F) , blood pressure is 112/60 mm Hg, pulse is 68/min, and respirations are 12/min.  Pulse oximetry shows 96% on room air.  Laboratory results are as follows: Which of the following is the most appropriate next step in management of this patient?

A) Fluid restriction
B) Intravenous hypertonic saline
C) Intravenous lactated Ringer solution
D) Intravenous naloxone
E) Intravenous normal saline

Correct Answer:

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