25 year old male with a background of quadriplegia (from previous motor MVA), presents to ED with altered level of consciousness. He has recently undergone surgery on him lower limbs to release strictures. The patient is not  known to be diabetic.

O/E BP 90/60 HR 110 Sats 93% RA Temp 36.5

GCS 14 Dry mucous membranes and CPR 3 seconds

VBG:

pH7.31                                   Na 171mmol/l

pCO2 53mmHg                     K 4.2mmol/l

pO2 55mmHg                        Cl 132mmol/l

HCO3 26mmol/l                    Cr 153umol/l

B/E -1                                    Glucose 41mmol/l

Lactate 4.1                            Urea 14.1

1. Describe and Interpret the VBG
2. What are causes of hypernatraemia?
3. How would you treat the hypernatraemia in this case?