What action should a nurse take first when assessing a peripheral IV site and noting blanching, coolness, and edema?

When assessing a peripheral IV site and noting signs such as blanching, coolness, and edema, the priority action is to remove the IV. This sequence is crucial because these symptoms indicate potential infiltration or extravasation, where the IV fluid is leaking into the surrounding tissue rather than remaining inside the vein. By removing the IV catheter immediately, the nurse can prevent further tissue damage, pain, or complications that could arise from continued leakage of fluid outside the vessel.

Once the IV is removed, the nurse should also employ appropriate measures such as elevation of the affected limb, monitoring for further swelling, and applying a warm compress if indicated, but these follow-up actions come after the initial removal. Notifying the healthcare provider is also important, but ensuring the patient's safety by removing the source of potential harm takes precedence. Other interventions like changing the IV solution would not address the immediate issue present at the site.