Question 1: Preventing Pulmonary Edema:

While predicting such a complication is not always possible, several nursing actions could have potentially reduced the risk of pulmonary edema in this case:

1. Enhanced Fluid Assessment: Regular monitoring of vital signs, especially blood pressure and heart rate, alongside frequent skin assessments for dryness and thirst could have provided early clues of dehydration.
2. Oral Rehydration Prioritization: Given the absence of severe electrolyte imbalances or altered mental status, prioritizing oral rehydration with electrolyte-rich fluids might have sufficed, avoiding the potential fluid overload from rapid IV infusion.
3. Monitoring Infusion Rate: In the absence of IV pumps, closely monitoring the infusion rate and slowing it down if the client shows signs of discomfort or respiratory distress, especially after receiving a significant volume, could have prevented fluid overload.
4. Early Recognition of Respiratory Symptoms: Promptly notifying the provider of any change in breathing patterns, cough, or discomfort during IV administration could have allowed for early intervention and possibly prevented pulmonary edema.

Question 2: Risk Factors for Pulmonary Edema:

This client faces several key risk factors for pulmonary edema:

1. Age: Elderly individuals have decreased kidney function and a weaker heart, making them more susceptible to fluid overload and heart failure.
2. Dehydration: Severe dehydration concentrates electrolytes in the blood, drawing fluid from the vascular space into the interstitial space, potentially leading to pulmonary edema.
3. Rapid Fluid Replacement: Large volume, rapid IV fluid administration, especially with normal saline, can overwhelm the compromised heart and lead to fluid accumulation in the lungs.
4. Underlying Conditions: The presence of undiagnosed heart disease, chronic kidney disease, or hypertension could further increase the risk of pulmonary edema.

By understanding these risk factors and implementing appropriate nursing interventions, healthcare professionals can potentially prevent similar complications in the future.