When a client who is receiving a potassium infusion via a peripheral intravenous (IV) site reports a burning sensation above the IV site, which action would the nurse take first?

• A. Check the IV access for a blood return.
• B. Apply warm compresses to the affected extremity.
• C. Slow the IV infusion until the burning sensation is gone.
• D. Request an oral supplement from the primary health care provider.

Answer: (A)

When a client receiving an IV potassium infusion reports burning along the IV site, the first priority is to determine whether the IV catheter is still in the vein and patent. Checking for a blood return quickly tells you if the line is intravascular. If there is a blood return, the line remains in the vessel, and the burning could be due to irritation or phlebitis, so you continue assessment and monitor the site closely. If there is no blood return, the line may have infiltrated and potassium could be leaking into the surrounding tissue, raising the risk of tissue injury; in that case, you would stop the infusion and remove the catheter and start a new IV at another site. Since potassium can damage tissue if extravasated, confirming intravascular placement first is the critical immediate step.