Review Question - QID 213877

A 55-year-old man is brought to the emergency department by his wife due to increased confusion and somnolence. The wife reports that his symptoms progressed over the course of 3 days. He also noticed some abnormal shaking in his bilateral upper extremities but denies any bowel or bladder incontinence or tongue biting. The patient has not experienced a fall or any recent medication changes. His past medical history is notable for ascites secondary to liver cirrhosis leading to portal hypertension, for which he underwent a transjugular intrahepatic portosystemic shunt. His temperature is 99°F (37.2°C), blood pressure is 140/85 mmHg, pulse is 89/min, and respirations are 18/min. On physical examination, he is alert to self but not place or date. He is able to follow simple one-step commands and has notable asterixis. Laboratory studies are shown below:

Serum:
Na+: 140 mEq/L
Cl-: 101 mEq/L
K+: 4.1 mEq/L
HCO3-: 24 mEq/L
BUN: 20 mg/dL
Glucose: 140 mg/dL
Creatinine: 0.9 mg/dL

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