What should the nurse do first when a client receiving IV fluids complains of pain at the site and swelling is noted?

When a client receiving IV fluids reports pain at the IV site and swelling is observed, the most immediate and appropriate action for the nurse is to stop the infusion and remove the IV catheter. This response is essential for several reasons.

First and foremost, pain and swelling can indicate a complication such as infiltration (where IV fluid leaks into the surrounding tissue), phlebitis (inflammation of the vein), or infection. Continuing the infusion could exacerbate these issues, potentially causing further discomfort or more severe complications.

By stopping the infusion, the nurse protects the client from additional harm. Removing the catheter allows for the potential evaluation of the site, including any assessments required to determine the extent of the complication. Once the catheter is removed, the nurse can apply appropriate interventions such as warm or cold compresses to alleviate discomfort and reduce swelling, depending on the identified issue.

In contrast, inserting a new IV in a different vein without addressing the current site could lead to further complications. Preparing for a PICC line placement is unnecessary at this stage, as it does not address the immediate issue of swelling and pain. Elevating the arm may help with swelling but would not be effective if the underlying cause—such as infiltration or phlebitis—is not managed first