An 8-year-old boy weighing 26 kg is brought to the emergency department after a 2-minute generalized tonic-clonic seizure that stopped on its own. He had a headache and vomited twice this morning. He has monosymptomatic nocturnal enuresis and started desmopressin oral melt at bedtime 2 weeks ago. Last night he was at a sleepover, where he drank large amounts of juice and water before going to bed. He has no history of seizures and takes no other medications. On examination he is drowsy but arousable, with no focal deficits and no signs of dehydration or edema. Serum sodium is 118 mmol/L (135-145), serum osmolality 247 mOsm/kg (275-295), glucose 5.4 mmol/L (3.3-5.5) and urine osmolality 410 mOsm/kg.
| Heart rate | 92/min |
| Respiratory rate | 20/min |
| Temperature | 36.8 °C |
| O2 saturation | 98%, room air |
| Blood pressure | 108/66 mm Hg |
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Which of the following are the most appropriate initial management steps?
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