Can you simply pick "normal saline" and change it to be a bolus?

The correct rationale for stating that a special bolus order is needed is rooted in clinical protocols and patient safety. In medical practice, fluids administered through a bolus—essentially a rapid infusion of a fluid—require specific orders to ensure that they correspond with the patient’s needs and health status. The decision to administer a bolus can depend on various factors including the patient's medical history, current condition, and the purpose of the fluid administration.

Simply picking a fluid like "normal saline" and converting it to be a bolus without an explicit order and proper context can lead to potential complications and is not within the standard practice. This ensures that healthcare professionals are held to protocols that prioritize patient safety and effective treatment methods. Therefore, a formal bolus order helps in determining the appropriate volume and rate, avoiding any risks of overloading a patient or other adverse effects.