What it means
A state of too much fluid volume inside the circulation. It happens most often when IV fluids or blood are given faster or in larger amounts than the client's heart and kidneys can manage. When it follows a blood transfusion it is called transfusion-associated circulatory overload (TACO). Older adults, infants and clients with heart or kidney failure are most at risk. Fluid can back up into the lungs and cause pulmonary edemaPUL-muh-nair-ee ih-DEE-muhA buildup of fluid in the air sacs and tissues of the lungs.pulmon/o lung-ary having to do withedema swelling with fluidFull entry .
For the nurse
During infusions and transfusions, watch for shortness of breath, cough, crackles in the lungs, a rising blood pressure, distended neck veins and new swelling. If these appear, slow or stop the infusion, sit the client up, give oxygen as ordered and tell the provider. Use an infusion pump and check the rate often in clients at risk.
In a chart
"Second unit of PRBCs paused: client dyspneic, crackles in both lung bases, BP up to 172/94; provider notified."
Related terms
heart failure
A long-term condition in which the heart cannot pump enough blood to meet the body's needs.
pulmonary edema
A buildup of fluid in the air sacs and tissues of the lungs.
blood transfusion
Giving blood, or a part of blood, from a donor into a person's vein.
infusion rate
How fast an IV fluid or drug flows into the client, usually written in milliliters per hour or drops per minute.