Why was the IV fluid rate increased to 125 mL/hour in this patient?

• A. To prevent fluid volume depletion and peritonitis
• B. To contribute to hyperglycemia
• C. To lower the risk of hyponatremia
• D. To speed clearance of antibiotics

Answer: (A)

The main concept here is maintaining adequate intravascular volume to prevent hypovolemia and its consequences in a patient with inflammatory bowel disease who is at risk for intra-abdominal complications. Increasing the IV fluid rate provides volume replacement for ongoing losses (such as diarrhea, vomiting, and poor intake) and helps sustain perfusion to vital organs, including the kidneys and the gut. When circulating volume is preserved, blood pressure stays more stable and tissue oxygen delivery remains adequate, reducing the risk of shock and further harm from developing peritoneal inflammation or infection. That’s why the rate is raised to prevent fluid volume depletion and peritonitis.

The other options don’t address the primary need. Higher IV fluids aren’t used to intentionally induce hyperglycemia. While maintaining volume can help avoid hyponatremia in some contexts, the key goal in this scenario is replacing losses to prevent hypovolemia and its consequences, not specifically lowering hyponatremia risk. Increasing fluids doesn’t speed antibiotic clearance in a meaningful way; antibiotic pharmacokinetics depend on distribution and elimination rather than simply the IV rate.