Which assessment indicates a client might be experiencing circulatory overload while receiving a unit of packed RBCs?

Dyspnea, or difficulty breathing, is a key indicator of circulatory overload in a patient receiving transfusions, such as a unit of packed red blood cells (RBCs). During the transfusion process, especially in cases where blood volume is rapidly increased, the heart may struggle to handle the excess fluid, leading to pulmonary congestion. This congestion manifests as dyspnea, often accompanied by other symptoms such as orthopnea, crackles in the lungs upon auscultation, and possibly even hypertension.

In this context, dyspnea not only suggests that the client's lungs are unable to effectively manage the increased volume but also raises concerns that the client's cardiovascular system may be at risk of failure due to the additional workload. Early recognition of this symptom is crucial for timely intervention, which can mitigate complications associated with fluid overload.

While the other symptoms listed may be of clinical significance, they are not directly indicative of circulatory overload. Flushing may occur for various reasons, and while bradycardia can indicate a complicated response to the transfusion, it is not as closely associated with fluid overload as dyspnea. Vomiting can arise from a range of causes but is not a primary sign of fluid overload during transfusion.