What action should be taken if the hourly IV fluid rate exceeds 1500 mL/hr in an adult burn patient?

If the hourly IV fluid rate exceeds 1500 mL/hr in an adult burn patient, the appropriate action is to switch to a 5% albumin infusion. This decision is based on the understanding that in burn management, the goal is to maintain adequate intravascular volume and tissue perfusion while minimizing the risks associated with excessive fluid volume.

When a patient is receiving such a high volume of fluids, they're at an increased risk of fluid overload and related complications, such as pulmonary edema. By switching to a 5% albumin infusion, you not only help manage the volume but also assist in restoring and maintaining oncotic pressure, as albumin is a colloid that helps keep fluid within the vascular system. This can provide a more effective means of fluid resuscitation, particularly after significant burn injuries, where capillary permeability is altered.

The other options may not adequately address the potential risks of fluid overload or fail to provide the necessary adjustments in fluid management that are crucial for burned patients requiring careful monitoring and specific resuscitation strategies. Using albumin helps to balance the fluid levels more appropriately and ensures that the patient's needs are met without risking complications from excessive fluid.