Which preparation steps are appropriate before placing an IV?

• A. Explain the procedure and rationale; use local anesthetic such as lidocaine or EMLA; inform the patient before needle insertion.
• B. Explain the procedure after insertion.
• C. Place the IV without the patient's awareness to avoid anxiety.
• D. Delay any anesthetic to avoid discomfort.

Answer: (A)

Clear communication and pain management before venous cannulation set the stage for a safe and comfortable experience. Explain the procedure and why it’s done, offer a local anesthetic such as lidocaine or a topical agent like EMLA, and inform the patient before inserting the needle. This respects the patient’s autonomy, reduces anxiety, and helps the cannulation go more smoothly, often on the first attempt. Explaining after insertion, performing it without the patient’s awareness, or delaying anesthetic would increase pain or distress and undermine consent.