Which finding would be of concern for fluid volume overload in a elderly patient receiving IV fluids at 125 mL/hr?

Which finding would be of concern for fluid volume overload in a elderly patient receiving IV fluids at 125 mL/hr?

• A. Anxiety
• B. Crackles noted in the bases of the lungs
• C. CVP 5 mmHg
• D. S3 heart sound

Answer: (B)

Fluid volume overload often shows up in the lungs first, because the excess fluid pushes into the interstitial and alveolar spaces, leading to pulmonary edema. Hearing crackles at the bases on lung auscultation means fluid is accumulating there and gas exchange is being impaired, which is a serious sign in someone receiving IV fluids. In an elderly patient, even a modest fluid administration can tip the balance toward overload, so basilar crackles prompt urgent reassessment of the IV rate and overall fluid status, and may lead to actions like restricting fluids or starting diuresis.

Anxiety is not a specific indicator of fluid overload. A CVP of 5 mmHg is within the normal to low range and does not point to overload. An S3 heart sound can be associated with increased filling pressures or heart failure, but crackles provide a more direct and urgent clue of actual pulmonary edema from excess fluid.