A nurse identifies early signs of phlebitis at a client's IV site. What is the priority nursing action?

A. Slow the infusion rate is incorrect because reducing the flow rate does not eliminate the cause of the irritation, the IV catheter and current infusion solution. As long as the catheter remains in the vein, mechanical irritation, chemical irritation (from the medication or solution), or bacterial irritation can continue to worsen. Slowing the infusion only delays the appropriate intervention and increases the risk of complications such as thrombophlebitis or infection. B. Apply a warm compress and continue monitoring is incorrect because warm compresses are an adjunct treatment after the catheter has been removed, not while it remains in place. Applying warmth without removing the catheter allows the source of inflammation to continue irritating the vein. Additionally, “continue monitoring” is insufficient because early phlebitis requires active intervention. Continuing the infusion despite early signs can lead to increased pain, swelling, redness, or even the development of a palpable cord. C. Flush the IV site with normal saline is incorrect because flushing an IV that shows signs of phlebitis can worsen damage by forcing fluid through an already irritated vein. This can increase pain, promote clot formation, and potentially dislodge a thrombus if one is developing. Flushing also increases the risk of introducing bacteria deeper into the venous system if the phlebitis has an infectious component. Therefore, flushing is contraindicated when inflammation is already present. D. Stop the infusion and remove the IV is correct because this is the priority intervention when early signs of phlebitis, such as redness, warmth, swelling, or tenderness along the vein, are identified. Removing the catheter immediately eliminates the source of irritation and prevents further injury to the vein. This intervention reduces the risk of progression to thrombophlebitis, infiltration, or infection. Once the IV is removed, the nurse should apply a warm compress to promote circulation and reduce discomfort, document the findings, and restart the IV at a different site if needed for ongoing therapy. This action reflects safe, evidence-based, and patient-centered nursing practice.