Final answer:
The nurse should discontinue the IV infusion (option 1) due to possible infiltration and initiate IV access at a different site (option 2) , followed by monitoring for complications. If signs of infection were present, as in the case study, cleaning and new dressing application along with antibiotics would be necessary.
Step-by-step explanation:
When a nurse is assessing a client on continuous IV therapy and observes that the client's IV access site is cool to the touch and the dressing feels moist, the appropriate action would be to discontinue the intravenous infusion immediately. This can be indicative of infiltration, where the IV fluid is infusing into the tissue surrounding the vein, rather than the vein itself. After stopping the infusion, the nurse should initiate IV access in a different site and monitor for any signs of complications such as swelling, pain, or reduced mobility.
If there are signs of infection such as warmth, redness, or a fever, as in the case of Barbara who had a localized infection at the catheter site, the nurse should clean the area with an antiseptic and follow the physician's orders, which may include applying a fresh dressing and the administration of an antibiotic like oxacillin. However, the current scenario described suggests infiltration rather than infection, given the coolness and moistness of the site, and therefore a warm compress is not advisable.