# A client receiving 25% albumin develops dyspnea, jugular venous distention, hypertension, and crackles. Which action should the nurse take?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522668&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client receiving 25% albumin develops dyspnea, jugular venous distention, hypertension, and crackles. Which action should the nurse take?

## Option

1. Increase the infusion rate because crackles indicate low oncotic pressure.
2. Stop the albumin infusion and obtain immediate volume and cardiopulmonary reassessment. **✔ Correct answer**
3. Dilute the remaining albumin with sterile water and continue the infusion.
4. Document the findings as expected and reassess after the entire bottle infuses.

**Correct answer: 2**

## Explanation

Dyspnea, jugular venous distention, hypertension, and crackles indicate hypervolemia or pulmonary edema during concentrated albumin therapy. Stop the infusion and reassess immediately.

## In-depth explanation

Quick answer
Treat new cardiopulmonary congestion during albumin as infusion-related volume overload.

Why this is correct
Concentrated albumin expands intravascular volume. Continuing or accelerating the infusion can worsen pulmonary edema, and sterile-water dilution can cause hemolysis.

Easy analogy or mental picture
Treat every infusion as a controlled clinical system: verify the product and access, recognize a changing cue, stop preventable exposure, stabilize the client, and confirm the response.

Memory hook
Product, access, compatibility, infusion cue, protective action, and reassessment.

NCLEX decision rule
Choose the action that prevents the most immediate infusion-related harm while preserving vascular access and the ordered diagnostic evidence.

Why the other choices are wrong
Options that restart a suspect product, bypass a safety device, force an occluded tube, or delay reassessment can convert a reversible warning into serious harm.References
1DailyMed: Albumin (Human) 25%Hypervolemia and pulmonary edema warnings, infusion interruption, hemodynamic reassessment, and dilution precautions

## Clinical scenario

Blood product, nutrition, and intravenous-fluid safety review
Verify the product, prescription, route, access device, filter or tubing, compatibility, baseline findings, emerging adverse cues, response plan, and measurable follow-up.

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