While you are obtaining a client's vital signs, he tells you that he is experiencing pain on his IV site. You check his right arm where the intravenous line is connected and notice that it is reddened. What should be your priority action?
A) Change the position of the clamp.
B) Regulate the flow rate to facilitate flushing.
C) Report the observation immediately to the licensed nurse.
D) Stop the flow rate, pull out the IV line aseptically, and report to the licensed nurse. This is a sign of phlebitis.
Correct Answer:
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