A client has IV infiltration. What is the priority action?

Rationale:
A. Allow clients to adjust the pump for comfort is incorrect because clients should not adjust IV infusion pumps. Doing so can lead to over- or under-infusion, incorrect dosing, and serious harm. Only trained healthcare personnel should program and adjust infusion pumps.

B. Skip site assessments if the client is asymptomatic is incorrect because IV site assessments are essential even when the client has no symptoms. Early detection of infiltration, phlebitis, or infection can prevent complications. Skipping assessments increases risk of tissue injury and systemic infection.

C. Administer medications only during low census is incorrect because timing administration based on staff workload does not improve patient safety. IV medications must be administered according to the prescribed schedule and safety protocols, regardless of census.

D. Use infusion pumps for IV medications when indicated is correct because infusion pumps provide precise control over the rate and volume of IV medications, especially high-risk drugs like vasoactive agents, electrolytes, and pediatric medications. Pumps reduce the risk of dosing errors, rapid infusion, or fluid overload, making them a highly effective safety practice.

Rationale:
A. Initiate and monitor peripheral IV therapy is correct. In Texas, LVNs are authorized to start and manage peripheral IV lines if they have completed the required training and competency verification. They can also monitor the infusion, assess the site, and report complications, under the supervision of an RN or provider per facility policy.

B. Administer IV push medications independently is incorrect because LVNs cannot independently give IV push medications in Texas. IV push administration is usually restricted to RNs and must follow facility policy, training, and delegation rules.

C. Prescribe IV fluids is incorrect because prescribing medications or fluids is outside the LVN scope of practice. Only licensed prescribers (physicians, nurse practitioners, or physician assistants) can prescribe IV therapy.

D. Insert a central venous catheter is incorrect because central line insertion is a complex procedure requiring advanced training, typically performed by physicians, advanced practice nurses, or RNs with specialized certification. It is outside the LVN scope.