MRCP2-2436

MRCP2-2436

A 32-year-old woman is brought to the emergency department by her husband due to lethargy for the past 2 days and increasing confusion this morning. She has no significant medical history and is currently 20 weeks pregnant.

Upon examination, the patient has a fever of 38.5ºC, a heart rate of 125 bpm, and a blood pressure of 115/95 mmHg. Her chest is clear, and her heart sounds are normal. Her abdomen is soft and non-tender, with a palpable uterus consistent with 20 weeks gestation.

The following are the patient’s laboratory results:
– Hb: 92 g/L (normal range for females: 115-160)
– Platelets: 43 * 109/L (normal range: 150-400)
– WBC: 6.3 * 109/L (normal range: 4.0-11.0)
– Na+: 138 mmol/L (normal range: 135-145)
– K+: 3.8 mmol/L (normal range: 3.5-5.0)
– Urea: 11.2 mmol/L (normal range: 2.0-7.0)
– Creatinine: 185 µmol/L (normal range: 55-120)
– Bilirubin: 32 µmol/L (normal range: 3-17)
– ALP: 35 u/L (normal range: 30-100)
– ALT: 85 u/L (normal range: 3-40)
– Albumin: 37 g/L (normal range: 35-50)
– CRP: <1 mg/L (normal range: <5) Urinalysis is negative, and a pregnancy test is positive. What is the immediate next step in treating this patient?