A nurse is assessing the peripheral catheter insertion site of a client who is receiving an infusion. The nurse notices redness and warmth to the touch around the insertion site. The nurse should document the finding as which of the following complications?
Infiltration
Extravasation
Circulatory overload
Phlebitis
The Correct Answer is D
Choice A reason:
Infiltration is not correct: Infiltration occurs when the infused fluid or medication leaks into the surrounding tissue instead of flowing into the vein. This can lead to swelling, coolness, and pallor around the insertion site.
Choice B reason:
Extravasation is not correct: Extravasation is similar to infiltration but specifically refers to the infiltration of vesicant medications, which can cause tissue damage and necrosis.
Choice C reason:
Circulatory overload is not correct: Circulatory overload occurs when a large volume of fluid is infused too quickly, overloading the circulatory system and potentially leading to fluid overload, pulmonary edema, and other related symptoms.
Choice D reason:
Phlebitis is the appropriate fingings. The nurse should document the finding of redness and warmth around the peripheral catheter insertion site as phlebitis. Phlebitis is the inflammation of a vein, often caused by mechanical irritation, chemical irritation, or infection. In this case, the redness and warmth at the insertion site are indicative of inflammation, which is a common sign of phlebitis.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
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Explanation
The correct answer is D. Informed consent is a process of providing information that enables the patient to make a decision to undergo a specific treatment. It requires time, patience and clarity of explanation. Consent should be obtained prior to surgery and ensure that the patient has sufficient time and information to make an informed decision. The provider should explain the indications, risks, benefits and alternatives of the procedure.
Correct Answer is D
Explanation
Answer: D. I will make sure that I can fit one finger between the mattress and the side of my newborn's crib.
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