To manage circulatory overload, which nursing action is appropriate?

• A. Increase the IV rate to flush the excess volume
• B. Elevate the HOB and monitor vitals
• C. Decrease the IV rate to a minimum (KVO), elevate HOB, assess lung sounds and edema
• D. Administer a diuretic without an order

Answer: (C)

Circulatory overload happens when there’s too much fluid in the circulation, which can lead to edema and pulmonary congestion. The best nursing action is to stop adding fluid and support breathing while monitoring the patient’s response. Keeping the IV line at the minimum rate (KVO) prevents further fluid from entering the circulation. Elevating the head of the bed helps decrease venous return to the heart, which can ease breathing and reduce pulmonary congestion. Regularly assessing lung sounds and edema provides objective feedback on improvement or worsening, guiding further treatment. Administering a diuretic without an order is unsafe and could cause electrolyte disturbances or hypotension, and increasing IV rate would worsen the overload. This approach directly limits the fluid load and monitors the patient’s response to therapy.