A 70-year-old woman fell at home and fractured her hip. You are called to the emergency department (ED) to evaluate the patient for impending surgery. The orthopedic surgeon who called you is writing the admission orders, including normal saline as the intravenous (I.V.) fluid. A recent prospective, randomized study compared outcomes in patients admitted to non–intensive care unit (ICU) beds. Which of the following outcomes is most likely in patients receiving saline compared to patients receiving a more balanced salt solution such as lactated Ringer’s solution?

I.V. fluid administration has been a mainstay of hospital medicine since World War I. Fluids are given to prevent dehydration in patients unable to tolerate oral intake and as a carrier for I.V. medications. Despite their ubiquity in clinical practice, however, none of the commonly used I.V. fluids have been scientifically validated in...

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