A nurse is monitoring an intravenous infusion for a client who is dehydrated. The nurse should discontinue the IV for which of the following findings?
Explanation & Rationale
Choice A reason: Serous drainage at the insertion site may indicate mild irritation but does not require discontinuation unless accompanied by signs of infection or infiltration. Choice B reason: A small air bubble in the tubing is generally harmless and does not require discontinuation. Large air bubbles pose a risk of air embolism, but small ones are typically absorbed without issue. Choice C reason: Blood return in the tubing indicates that the IV catheter is correctly placed in the vein. This is a normal finding and does not require discontinuation. Choice D reason: Blanched skin at the insertion site indicates infiltration, meaning IV fluid is leaking into surrounding tissue rather than the vein. This can cause tissue damage and requires immediate discontinuation of the IV to prevent complications.