Caring for frail, elderly patients with complex conditions demands precision — and in this episode of Clinical Adventurer, we walk through a real-world case of severe hypernatremia, acute kidney injury, and metabolic acidosis in a vulnerable patient with DNR/DNI status. You’ll learn the rationale behind treatment choices like D5W with KCl, cautious sodium bicarbonate administration, and stopping competing infusions to avoid dangerous osmotic shifts. We’ll also cover key nursing priorities: meticulous monitoring, fluid management, and ethical considerations in high-risk care. This is practical, case-based insight you can take straight to the bedside.