A client receiving IV fluids suddenly develops dyspnea and crackles. The LVN should suspect:

Rationale: A. Air embolism occurs when air enters the venous system and obstructs blood flow. Signs typically include sudden chest pain, hypotension, tachycardia, and sometimes a “mill wheel” murmur. Dyspnea may occur, but crackles are not a hallmark feature, making this less likely. B. Phlebitis is inflammation of the vein, characterized by redness, warmth, tenderness, and a hard vein at the IV site. It is a local reaction and would not cause systemic symptoms such as dyspnea or pulmonary crackles. C. Fluid volume overload is correct. Excess IV fluids can overwhelm the cardiovascular system, especially in clients with heart or kidney impairment. The LVN should recognize signs such as dyspnea, crackles on auscultation, elevated blood pressure, jugular vein distention, and edema. Crackles indicate pulmonary congestion, a hallmark of fluid overload. Immediate nursing actions include slowing or stopping the IV, elevating the head of the bed, monitoring vital signs, and notifying the provider. D. Infiltration occurs when IV fluid leaks into surrounding tissue, causing localized swelling, pallor, and cool skin at the site. It does not produce systemic respiratory symptoms such as dyspnea or pulmonary crackles.