After administering isotonic saline bolus for hypotension, how should reassessment occur?

• A. Reassess every 250 mL
• B. Reassess after the entire 2 L given
• C. Reassess hourly
• D. No reassessment

Answer: (A)

The main idea is to monitor the patient continuously as you give fluids, so you can tailor the resuscitation to their actual response. Reassessing after every 250 mL of isotonic saline makes sense because people respond differently: some show rapid perfusion improvements with only a small amount, while others may not respond or may begin to show signs of fluid overload. By checking vital signs and perfusion indicators after each incremental bolus, you can stop early if the patient has adequate response, continue with additional fluid if needed, or switch to other therapies if there’s no benefit or there are signs of harm.

Useful signs to reassess include blood pressure and MAP, heart rate, mental status, urine output, capillary refill, and overall perfusion. Waiting until the entire 2 liters are given risks missing an early improvement or, worse, signs of overload, which is why frequent reassessment is preferred.