A patient presents with confusion and seizures and a serum sodium of 118 mEq/L after excessive fluid intake. What is the electrolyte disorder and the safest initial treatment approach?

• A. Hyponatremia; treat with cautious correction using hypertonic saline (3% NaCl) in a controlled setting, aiming to raise Na by 4-6 mEq/L in the first 6 hours.
• B. Hypernatremia; rapid correction with isotonic fluids.
• C. Hypokalemia; IV potassium chloride treatment.
• D. Hyperkalemia; IV calcium gluconate followed by shift of potassium intracellularly.

Answer: (A)