During an intermittent IV infusion of phenytoin, the patient reports burning at the infusion site. What is the priority nursing action?

• A. Assess the intravenous catheter insertion site
• B. Notify physician and discontinue infusion
• C. Elevate the arm
• D. Administer analgesic

Answer: (A)

Burning at the IV site during phenytoin infusion signals possible IV irritation, infiltration, or extravasation, which can cause tissue injury if not addressed. The priority action is to assess the IV catheter insertion site—check for red or swollen skin, coolness or warmth along the vein, leakage, and determine if the line is patent and properly placed. This assessment tells you whether the infusion should be stopped or moved to a new site and what further steps are needed. While stopping the infusion and notifying the physician may be necessary based on what you find, the first, most important move is to inspect and evaluate the IV site to guide safe management. Elevating the arm or giving analgesics won’t resolve the underlying issue, and proceeding without assessment could worsen injury.