Difficulty: Medium
Average Score: 77%
Simulated
A nurse is assessing a client who is receiving continuous IV therapy through a peripheral IV. The catheter site is cool and taut
Correct answer
C
Rationale
The correct answer is C: Infection. A cool and taut catheter site in a client receiving IV therapy may indicate an infection. Infections can cause localized inflammation and result in the catheter site feeling cool and taut. The nurse should assess for other signs of infection such as redness, pain, swelling, and warmth at the site. IV fluid leaking would more likely indicate infiltration (choice D) rather than infection. Phlebitis (choice B) refers to inflammation of the vein, typically presenting with redness and tenderness along the vein. Circulatory overload (choice E) would manifest with symptoms such as shortness of breath and increased blood pressure, not a cool and taut catheter site.