Lactated Ringer's solution is contraindicated in patients with which condition?

• A. Dehydration
• B. Hypovolemic shock
• C. Renal failure
• D. Congestive heart failure

Answer: (D)

Lactated Ringer's is a crystalloid fluid that adds volume to the intravascular space. In congestive heart failure, the heart already struggles to pump effectively, so giving more fluid increases preload and venous return. That extra volume can raise filling pressures and push fluid into the lungs, leading to pulmonary edema and worsened heart failure. That’s why LR is avoided in CHF.

In dehydration or hypovolemic shock, expanding the circulating volume helps restore perfusion and tissue oxygen delivery, so LR is appropriate there. For renal failure, fluid management is more complex and may raise electrolyte concerns, but the standout reason here is the risk of fluid overload in heart failure.