If an elderly person has renal impairment, chf & hypernatremia (sodium presently 157 mmol/l) would it seem to be appropriate for him to be on a normal saline iv fluid? other conditions are copd, pleural effusion, t2 diabetes, delirium, mild hepatic dysfun

May be not !!!!: Fluid management in a complex patient is a very complex issue and a strait forward yes or no is not the answer. Amount of fluid administered along with medications being given make it further complex. There is no harm bringing up this question with patient's current physicians.

Multiple med problem: I would consider 1/4 N.S. a more appropriate fluid. Sounds multiple system are failing and he has a very high mortality. If one can correct the CHF and CRF then the other factors may correct themselves, but doubt that Hemodialysis is indicated in a 91 y/o