Review Question - QID 213530

A 62-year-old man presents to the emergency department with confusion. The patient’s wife states that her husband has become more somnolent over the past several days and now is very confused. The patient has no complaints himself, but is answering questions inappropriately. The patient has a past medical history of diabetes and hypertension. His temperature is 98.3°F (36.8°C), blood pressure is 127/85 mmHg, pulse is 138/min, respirations are 14/min, and oxygen saturation is 99% on room air. Physical exam is notable for a confused man with dry mucous membranes. Initial laboratory studies are ordered as seen below.

Serum:
Na+: 135 mEq/L
Cl-: 100 mEq/L
K+: 3.0 mEq/L
HCO3-: 23 mEq/L
BUN: 30 mg/dL
Glucose: 1,299 mg/dL
Creatinine: 1.5 mg/dL
Ca2+: 10.2 mg/dL

Which of the following is the most appropriate initial treatment for this patient?