A client receiving IV fluids through a peripheral venous access device shows swelling and tenderness at the infusion site. What action should you take first?

A client receiving IV fluids through a peripheral venous access device shows swelling and tenderness at the infusion site. What action should you take first?

• A. Stop the infusion and remove the PVAD
• B. Remove the dressing and reposition the PVAD
• C. Instruct the client to perform range of motion activities in the affected arm
• D. Place the arm in a dependent position

Answer: (A)

Swelling and tenderness at the IV site point to infiltration—the IV fluid is leaking into surrounding tissue. The first action must be to stop the infusion and remove the IV cannula to prevent any further tissue exposure and damage. Once the device is out, elevate the limb to reduce swelling, inspect the site for signs of infiltration (color, temperature, pain), and follow your facility’s protocol for ongoing care or redeployment of IV access. The other actions wouldn’t stop the ongoing leakage or would delay proper management and could worsen tissue injury.

Swelling and tenderness at the IV site point to infiltration—the IV fluid is leaking into surrounding tissue. The first action must be to stop the infusion and remove the IV cannula to prevent any further tissue exposure and damage. Once the device is out, elevate the limb to reduce swelling, inspect the site for signs of infiltration (color, temperature, pain), and follow your facility’s protocol for ongoing care or redeployment of IV access. The other actions wouldn’t stop the ongoing leakage or would delay proper management and could worsen tissue injury.