Hyponatremia

First thing I always think of is lab error requiring a potential repeat lab draw but assuming this value is real, I’d go back to the patient’s bedside: Is she taking any medications/diuretics? Any symptoms for a PNA/Legionella? Neurologic exam (though sounds like she isn’t symptomatic)?

The next typical medicine workup is to figure out if she is hypovolemic, euvolemic or hypervolemic and I’d add on a serum osmolality, urine osmolality, and a urine sodium to try to determine the cause.