Brainstorming about tomorrow's pt


Any ideas as to why this patient might be on 1/2 NS @ 75mL hr?

68 years old, morbidly obese female, admitted with sepsis from UTI and C. diff. Patient also has CRF, CHF, severe pulmonary HTN (and a slew of other comorbidities, but these seem to be the most relevant to my concern)

BUN and creatinine are HIGH, crcl is low. Hgb and Hct are low.

I'm concerned about fluid volume and going in tomorrow and pumping this CRF/CHF patient full of hypotonic fluid. I'll certainly be monitoring for signs of fluid overload (watching respiration, listening to lung sounds, I&O, assessing for bounding pulses) , but is.... there something I'm overlooking?

Is hypotonic right? Do you guys see hypotonic solutions being given to CRF patients a lot? This is the first time I've ever had a patient on a hypotonic solution, which might be why I'm a little uneasy about it.

Thanks for any ideas!