Quote Originally Posted by HogFan
I think Normal saline is the right choice as long as they are not exibiting signs of seizures. Use of hypertonic can cause a rapid increase in serum Na+ and result in central pontine myelinolysis worsening your problems.

I don't have my books handy, so I may be wrong about this.
most of the literature i've read cited a sodium level of 120 or less as being a critical level, and should be treated. with that said, i agree with what you said about the adverse effects of administering saline too fast. the treatment will depend on total body sodium and volume, so i guess it's hard to pinpoint the best choice given here.
what i can say, is that with a level of 114, you are very close to neurologic changes. and seizures won't be the only s/sx. i'd be concerned at this point, and if pt is under GA (which my TUPRS always are), it makes it that much harder to determine effects of low sodium.