A postoperative abdominal surgery patient who is NPO has an IV of Ringer's solution at 124 ml/h via gravity. At 0100 you find 150 ml has been infused since 0700. What is your initial course of action?

• A. Increase infusion rate
• B. Check tubing and infusion for obstruction
• C. Call physician
• D. Record as normal

Answer: (C)

Recognize when IV fluid administration is not meeting expectations in a postoperative, NPO patient. A gravity IV set at a defined rate should deliver close to the ordered volume; seeing only 150 ml infused over a long interval indicates the line may not be delivering as prescribed and poses a real risk of hypovolemia and electrolyte imbalance. In this situation, the priority is to involve the physician so they can review orders, assess the patient, and decide whether to adjust the infusion rate, replace the IV, or take other corrective action. While checking the tubing for a kink or obstruction is a reasonable bedside check, the safety-critical step here is to obtain medical guidance promptly to prevent further fluid deficit and complications.