Which complication of I.V infusion can cause pulmonary oedema or heart failure?

HPSSSB Staff Nurse - 2016

Nursing Foundation

Easy

Appeared in: HPSSSB Staff Nurse - 2016

Explanation

Circulatory overload is a systemic complication caused by infusing an excessive volume of IV fluid or administering it too rapidly.
This leads to hypervolemia (fluid volume excess), which increases the workload on the heart.
The overwhelmed heart cannot pump effectively, causing blood to back up into the lungs. This increased pressure forces fluid into the alveoli, resulting in pulmonary edema.
Key signs include shortness of breath, crackles on lung auscultation, distended neck veins, and increased blood pressure, which are indicative of both pulmonary edema and heart failure.

Option A: Infiltration is a local complication where IV fluid leaks into the subcutaneous tissue around the insertion site. It causes localized swelling, coolness, and pain, but does not cause systemic issues like pulmonary edema or heart failure.
Option B: Infections related to IV therapy can be local or systemic (sepsis). While severe sepsis can eventually lead to cardiac dysfunction, it is an inflammatory response to pathogens, not a direct consequence of fluid volume.
Option C: A pyrogenic reaction is a febrile response to contaminants in the IV solution or tubing. It is characterized by fever, chills, and malaise, not by signs of fluid volume excess like pulmonary edema.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Systemic complications of intravenous therapy as background academic context rather than a clinical decision trigger.
Nurses must carefully monitor the rate of IV infusions, especially in vulnerable populations such as the elderly, infants, and patients with pre-existing cardiac or renal conditions.
Accurate intake and output monitoring is crucial for early detection of fluid imbalance.
Regular patient assessment, including checking vital signs, lung sounds, and for edema or jugular vein distention, is a key nursing responsibility to prevent or manage circulatory overload.

How to Approach the Question

First, analyze the question to identify the core concept. The keywords are "I.V. infusion complication," "pulmonary oedema," and "heart failure."
Recognize that pulmonary edema and heart failure are serious, systemic conditions related to fluid balance and cardiac function.
Evaluate each option based on its primary mechanism and site of effect (local vs. systemic).
Infiltration is a local issue where fluid escapes the vein.
Infection and pyrogenic reactions are caused by microorganisms or contaminants, not directly by fluid volume.
Circulatory overload is defined as an excess of fluid in the circulatory system.

Concept Tested & Keywords

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