The simple PLRM can be a nurse-driven action if it does not go against hospital policy. There are situations in which the PLRM may be contraindicated or when the patient cannot tolerate it. For example, PLRM cannot be used in clinical situations such as trauma of the hip, legs, or lumbar spine; deep venous thrombosis; and intracranial or abdominal hypertension. In these situations, other stressors may be used such as a mini-fluid challenge or a ventilator change.1,2 

Fluid amounts for assessing responsiveness range from 1 to 5 mL/kg to 50 to 500 mL. Time frames for administering a fluid challenge also vary from 1 minute up to a maximum of 30 minutes. Most current recommendations are for a smaller amount of fluid over a shorter period.3–5 

Although all fluids have different properties, the type of fluid used does not demonstrate a mortality difference.5...

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