The nurse is preparing to administer an intravenous vesicant medication to a client. Which of the following findings should the nurse identify as a complication of extravasation?

Choice A reason: Explaining that all people feel anxious minimizes the client’s concerns, potentially dismissing valid fears. This does not address specific anxieties, which may escalate, impacting recovery or consent. Encouraging expression fosters therapeutic communication, making this a less effective approach for addressing preoperative anxiety.

Choice B reason: Suggesting the client talk to the provider may clarify surgical concerns but delays immediate emotional support. Nurses can address anxiety through therapeutic communication, making it more appropriate to encourage expression of feelings rather than deferring to the provider initially for emotional support.

Choice C reason: Distracting the client by changing the subject avoids addressing anxiety, which may worsen emotional distress and affect surgical outcomes. Unresolved anxiety increases stress hormones, impacting recovery, making this ineffective compared to encouraging open expression of the client’s concerns.

Choice D reason: Encouraging the client to express feelings addresses preoperative anxiety, reducing stress hormones like cortisol that impair healing. Therapeutic communication validates fears, promotes coping, and enhances trust, making this the most effective nursing action to support emotional and physical preparation for surgery.

Choice A reason: Air embolism occurs when air enters the bloodstream, not from vesicant extravasation. Vesicants, like chemotherapy drugs, cause local tissue damage when leaking outside the vein, leading to necrosis, not vascular occlusion, making air embolism an incorrect complication in this context.

Choice B reason: Tissue necrosis is a primary complication of vesicant extravasation, as these medications (e.g., chemotherapy agents) are toxic to tissues outside the vein. Leakage causes severe damage, leading to cell death, ulceration, and potential tissue loss, making this the critical complication to identify and manage.

Choice C reason: Edema may occur with extravasation due to fluid leakage but is not the primary concern with vesicants. Vesicant extravasation causes severe tissue damage, leading to necrosis rather than just swelling, making edema a less specific and severe complication in this scenario.

Choice D reason: Thrombus formation is a risk with intravenous catheters but not a direct result of vesicant extravasation. Vesicants cause chemical damage to tissues, leading to necrosis, not clot formation, making thrombus an incorrect choice for vesicant extravasation’s primary effect.