Which cues indicate the patient may have fluid volume overload?

The correct indication of fluid volume overload in this context is orthopnea, which is the difficulty in breathing that occurs when lying flat and is often relieved by sitting up. This symptom arises because excess fluid in the body can lead to pulmonary congestion, especially when lying down. It signals that the cardiovascular system is overwhelmed, causing respiratory distress as fluid accumulates in the lungs.

Other clues such as bibasilar crackles, a low pulse oximetry reading, and weight gain can also result from fluid overload. Bibasilar crackles are indicative of fluid in the lungs but are part of a broader clinical picture rather than a specific cue. A pulse oximetry reading of 92% suggests potential oxygenation issues which can be common in various conditions, including pulmonary edema due to fluid overload, but by itself does not directly signify overload. The weight gain of 5 pounds since yesterday could indicate fluid retention; however, daily weight changes need to be interpreted in context with other clinical signs and symptoms. Thus, orthopnea serves as a more direct and immediate cue for clinicians assessing a patient for fluid volume overload.