A nurse notices the IV fluid rate is too fast for a patient receiving 0.45% sodium chloride. What is the priority nursing action?

The priority nursing action when noticing that the IV fluid rate is too fast is to reduce the IV flow rate. This action is crucial because an excessively rapid infusion can lead to complications such as fluid overload, electrolyte imbalances, or both, especially when administering a hypotonic solution like 0.45% sodium chloride. By reducing the flow rate, the nurse can immediately mitigate potential risks to the patient’s safety and well-being.

While notifying the physician is also important, it is not the most immediate concern; the patient's safety must be prioritized first. Tightening the IV line may not effectively address the issue of a fast flow rate and could potentially worsen it if not done carefully. Changing the IV bag may be necessary later but does not address the immediate problem of the current flow rate. Thus, reducing the IV flow rate is the most appropriate and direct action to ensure the patient's safety.