Which of the following are basic signs indicating congestive volume overload?

• A. Clear lungs with no edema
• B. Hypotension with tachycardia only
• C. Hyperactivity and weight loss
• D. Elevated jugular venous pressure, peripheral edema, pulmonary crackles, hepatomegaly

Answer: (D)

Volume overload shows up as venous and tissue congestion from excess fluid. Elevated jugular venous pressure reflects backup of blood into the right heart and veins; peripheral edema arises as fluid leaks into the interstitial spaces from high capillary hydrostatic pressure; pulmonary crackles signal fluid in the lungs from interstitial and alveolar edema; and hepatomegaly results from congested liver due to backlog of venous blood. Together, these findings are classic for congestive volume overload. In contrast, a scenario with clear lungs and no edema would not indicate overload, hypotension with tachycardia alone doesn’t define fluid excess, and weight loss or hyperactivity is not characteristic of volume overload.