A nurse is preparing to administer a fluid bolus to a child in septic shock. What type of fluid and over what duration should the nurse expect the provider to order?

Choice A rationale Hypotonic saline is not the fluid of choice for septic shock because it lowers serum osmolality and can shift fluid into the cells, worsening intravascular volume depletion and hypotension. A 20 mL/kg bolus is the correct volume, but the fluid type and 10 minutes duration are inappropriate for initial resuscitation. Choice B rationale The volume of 5 mL/kg is insufficient for the initial resuscitation of a child in septic shock, where the goal is rapid, aggressive replacement of intravascular volume lost due to capillary leak and vasodilation. A 20 mL/kg bolus is the standard. Ringer's lactate is an acceptable crystalloid, but the volume is wrong. Choice C rationale 𝐃5𝐖 (5. Choice D rationale 0.9% 𝐍𝐚𝐂𝐥 (𝐧𝐨𝐫𝐦𝐚𝐥 𝐬𝐚𝐥𝐢𝐧𝐞) is an isotonic crystalloid and is the preferred initial fluid choice to expand the intravascular volume rapidly without risk of electrolyte shift. The dose of 20 mL/kg is standard and must be administered rapidly, typically over 5-30 minutes, to correct hypovolemia and improve cardiac output.