A nurse plans to administer to a patient a fluid challenge for the purpose of establishing normal renal perfusion. What does this treatment involve?

Question

1. Infusing 250 mL of 0.9% sodium chloride over 1 hour
2. Administering albumin intravenously, followed by furosemide
3. Infusing 500 mL of normal saline over a 30-minute period
4. Giving twice the amount of IV fluid each hour compared to urinary output

Answer 1

3
Rationale 1: This is too slow of a rate and too little volume.
Rationale 2: The use of albumin and furosemide are not used as an initial fluid challenge. This therapy is done later to possibly stimulate the nephrons.
Rationale 3: A fluid challenge is the infusion of a bolus of 250 to 500 mL of normal saline rapidly. Although definitions of rapid administration vary depending on the circumstances, a fluid challenge of 500 mL may be administered over half an hour.
Rationale 4: Basing the amount of IV fluid to give on urinary output would be inappropriate. A fluid challenge is a large bolus that is administered quickly to rapidly hydrate the patient.