Which patient group is at highest risk for fluid overload during IV therapy?

• A. Teenagers with tonsillitis
• B. Adults undergoing minor surgery with no comorbidities
• C. Elderly with cardiac, renal, or liver disease or very young children
• D. Middle-aged athletes without health issues

Answer: (C)

The main idea is that the body’s ability to regulate fluids becomes limited when there’s organ impairment or when the patient is very young, so IV fluids can more easily push them into fluid overload.

Elderly patients, especially those with cardiac, renal, or liver disease, have reduced reserve to handle extra fluid. The aging heart may not pump as effectively, kidneys may not excrete sodium and water efficiently, and liver disease can alter protein levels and fluid distribution. These factors mean even modest IV fluid administration can accumulate and lead to edema, pulmonary congestion, or hypertension.

Very young children are also at high risk because they have a higher total body water percentage and immature kidneys that don’t regulate fluid and electrolytes as well. Their narrow physiologic margin means that standard IV fluid rates can quickly cause overload.

In contrast, healthy adults undergoing minor surgery or physically active middle-aged individuals without comorbidities have greater compensatory capacity to manage IV fluids, making fluid overload less likely in typical IV therapy scenarios.