For the IV bolus directive when one of the contraindications is fluid overload, if a patient has CHF and is presenting hypotensive, and is not experiencing SOB but has chronic edema in his/her feet/legs is that technically a contraindication to not bolus? Considering that would fall under fluid overload ? What are the signs and symptoms of fluid overload you guys are wanting us to look out for and be aware of?

Per the OBHG Companion Document, Pulmonary edema is a sign of fluid overload secondary to a fluid bolus. As such, frequent chest assessments are required.  Therefore, please auscultate for crackles. Pedal edema in the absence of pulmonary edema not considered a contraindication to IV bolus.

Cardiac/Circulation,Intravenous and Fluid Therapy

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