What is a critical step when administering hypertonic saline in severe hyponatremia?

Administering hypertonic saline requires a careful approach, particularly in cases of severe hyponatremia. The correct choice is to infuse slowly in small amounts due to the risk of causing rapid shifts in serum sodium levels. Rapid correction of hyponatremia can lead to serious complications such as osmotic demyelination syndrome, which can occur if the sodium level rises too quickly.

By infusing hypertonic saline slowly, healthcare providers can monitor the patient’s response and adjust the treatment as necessary, ensuring that sodium levels are restored safely and effectively. This approach allows for more precise management of the patient's condition, balancing the need to correct the electrolyte imbalance while minimizing the risk of adverse effects.

Other options do not align with best practices: infusing quickly can lead to dangerous complications, and administering treatment only if there are no symptoms overlooks the urgent need for careful management in symptomatic patients. Moreover, hypertonic saline should not be considered the primary treatment in isolation; it should be part of a broader treatment strategy that includes monitoring and addressing the underlying causes of the hyponatremia.