May need observed Na correction
Welcome to healthcare Magic!
Your elderly lady relative is apparently very sick and has many comorbid conditions. such patients are typically susceptible to infections like pneumonia
and urinary tract
infections and develop a condition called SIADH, marked by hyponatremia
. Patient may develop hyponatremia due to poor intake due to stupor
and may develop stupor due to hyponatremia. So a complex relationship.
I would suggest get her examined by a local physician and get Complete blood counts, Renal function tests, urine routine and culture and a chest Xray.
If any infection is detected then it should be treated with suitable antibiotics.
If urea and creatinine
are not raised then she should have restricted fluid intake to less than 1-1.5 litres a day depending on her weight. There are options of giving additional edible salt about 3grms 8hourly.
The correction of sodium should not be fast and the sodium increase should not exceed > 10Meq in a day otherwise patients may slip into Osmolar demyelination
and become comatose.
For that reason she should be closely watched by a local doctor and serum sodium levels should be done every 12 hourly during active correction.
In resistant cases a drug Tolvaptan can be added under physician supervision.
I hope the advise would be informative and useful for you.