True or false: A patient with renal or heart failure is usually not given normal saline because it promotes fluid retention.

• A. True
• B. False
• C. Depends on the situation
• D. Only with diuretics

Answer: (A)

The main idea here is how fluid management works in heart or kidney failure. Normal saline is isotonic, so it expands the extracellular fluid volume. In someone with heart failure or impaired kidney function, the body already struggles to handle sodium and water, so adding more saline increases preload and promotes fluid retention. This can worsen edema and precipitate pulmonary congestion or heart failure symptoms. Because of that, normal saline is usually avoided in these patients unless there's a specific need to correct hypovolemia or hypotension, in which case careful, limited use is guided by the clinician. The typical approach is fluid restriction and diuretics, with close monitoring of intake and output and daily weights.