Review Question - QID 104743

A 52-year-old man is brought to the emergency department for progressive confusion over the past 48 hours. He is otherwise healthy and takes no medications. His temperature is 100.6°F (38.1°C), blood pressure is 138/78 mmHg, pulse is 72/min, and respirations are 18/min. Examination reveals an ill-appearing man. He is drowsy but arousable. He is oriented to person, but not to place or time, and has no focal neurological deficits. Laboratory studies are ordered as seen below

Blood:
Hemoglobin: 8.2 g/dl
Hematocrit: 26%
Leukocyte count: 11,500/mm^3 with normal differential
Platelet count: 30,000

Serum:
Na+: 142 mEq/L
Cl-: 98 mEq/L
K+: 4.9 mEq/L
HCO3-: 22 mEq/L
Urea nitrogen: 45 mg/dl
Glucose: 112 mg/dl
Creatinine: 2.2 mg/dl

A peripheral smear is obtained as shown in Figure A. Which of the following is the most appropriate treatment in this patient?