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Still obtain appropriate serum and urine studies as you can assess response to interventions (urine output, change in urine concentration and serum sodium) and the patients current ADH/EABV state Pearl 2 Serum Osmolality (Normal value 280-285 mOsm/kg) We expect patients with true hyponatremia to have a low osmolality ( 280-285 mOsm/kg), or if normal osmolality without elevated proteins/lipids, look for extra osmoles, either measured or unmeasured

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