A hypovolemic patient with hypotonic hyponatremia should be given what type of fluids?

In a hypovolemic patient with hypotonic hyponatremia, the best choice is normal saline. Normal saline, which is a 0.9% sodium chloride solution, provides both volume resuscitation and sodium replacement. When a patient is hypovolemic, there is a loss of both fluid and sodium in the body, so administering normal saline helps to restore the intravascular volume and correct the sodium deficit effectively.

This choice is particularly important because it does not introduce excess solute that can further complicate the hyponatremia. Isotonic saline provides an appropriate level of sodium and helps to address both the fluid deficit and the electrolyte imbalance without causing additional shifts or complications.

Other options have distinct limitations. Isotonic saline and hypertonic saline can lead to shifts in fluid balance that may exacerbate the hypotonic state or cause cellular dehydration. Half-normal saline does not provide adequate sodium for a patient experiencing hypovolemic hypotonic hyponatremia, as it contains less sodium than normal saline and could further dilute serum sodium levels. The focus for treatment in these patients should be to stabilize their volume status efficiently while also correcting any electrolyte imbalances judiciously.