to give or not to give, that is the question?8)

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Specializes in critical care,flight nursing.

Got a patient in the ER. Man found by landlord on the floor. Last seen normal 10 days ago. Come in with slurred speech( resolving), R side weakness( uper worse then lower). Sodium at 165. Ck normal and no myoglobin in urine but it look very dark tea colour. On CT, intracranial bleeding vs possible tumor. They are unsure because of the way it look. Waiting for MRI. Very hypertensive( in the 200/120 range). My question, order to infuse .45 saline at 100 cc/h. I know with hyponatremia you have to be careful with fluids but I always though hypotonic fluids was a big no non with neuro event,should we still go ahead?

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