ATI LPN Comprehensive Predictor 2023 Proctored Exam 3
A nurse is caring for a client who is receiving a continuous IV infusion. The nurse notes that the skin around the catheter's insertion site is edematous and cool. Which of the following actions should the nurse take first?
Explanation & Rationale
A. Incorrect. Elevating the arm might help reduce edema, but the priority is to stop the infusion to prevent further infiltration. B. Incorrect. While documenting the infiltration is important, immediate action should be taken to stop the infusion to prevent further complications. C. Correct. The nurse's first action should be to stop the infusion to prevent the continuation of fluid infiltration and potential complications. D. Incorrect. Applying a warm compress might help with comfort, but stopping the infusion is the priority to prevent further infiltration.
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