A nurse is assessing clients who have intravenous therapy prescribed. Which assessment finding for a client with a peripherally inserted central catheter (PICC) requires immediate attention?

Choice A reason: A 3-day-old dressing should be changed per protocol to prevent infection, but it is not an immediate emergency. Swelling indicates potential complications like thrombosis or infiltration, requiring urgent intervention to prevent severe outcomes.
Choice B reason: A PICC inserted 4 weeks ago is within normal duration for use, provided no complications arise. Routine monitoring is needed, but swelling is a more urgent finding, indicating possible vascular or catheter issues.
Choice C reason: An absent securement device risks catheter dislodgement, which is concerning but less urgent than swelling. Swelling may signal thrombosis or fluid extravasation, necessitating immediate action to prevent circulatory or tissue damage.
Choice D reason: Upper extremity swelling may indicate thrombosis, infiltration, or infection, which are serious PICC complications. Thrombosis can obstruct blood flow, risking embolism, while extravasation causes tissue damage. Immediate assessment is critical to ensure patient safety.

Choice A reason: Hanging IV fluids for 72 hours increases bacterial contamination risk, as fluids provide a medium for microbial growth. Most protocols recommend changing bags every 24 hours to maintain sterility and prevent bloodstream infections.
Choice B reason: A 48-hour duration exceeds standard guidelines for IV fluid bags, risking microbial growth and contamination. Changing bags every 24 hours minimizes infection risk, ensuring patient safety during intravenous therapy.
Choice C reason: A 36-hour duration still poses a contamination risk, as IV fluids can harbor bacteria over time. Standard practice requires changing bags every 24 hours to prevent catheter-related bloodstream infections and ensure sterile delivery.
Choice D reason: IV fluids should hang no longer than 24 hours to minimize bacterial growth and contamination risks. This standard ensures sterility, reduces catheter-related infections, and maintains safe fluid administration for patient safety.