What should the nurse do if the patient's IV site is noted to be pale, cool, and edematous?

When the intravenous (IV) site presents with signs such as being pale, cool, and edematous, these indications suggest the possibility of infiltration or extravasation, where the IV fluid is no longer properly entering the vein and instead is leaking into the surrounding tissues. This can lead to further complications, including tissue damage.

The most appropriate action involves stopping the infusion immediately to prevent additional fluid from entering the surrounding tissue, thereby reducing the risk of further swelling or potential injury. Elevating the extremity helps to minimize swelling and promotes better venous return. Starting a new IV at an alternate site ensures that the patient can continue receiving necessary fluids or medications without risking complications at the infiltrated site.

Continuing the infusion would worsen the condition by allowing more fluid to accumulate outside the vessel. Simply notifying the physician without taking immediate action could delay needed interventions, and applying a warm compress alone does not resolve the underlying issue of compromised vascular access. Thus, the comprehensive approach of stopping the infusion, elevating the extremity, and initiating a new IV is the most appropriate course of action in this situation.