If a patient has pain at the venous needle site with distal swelling and rising venous pressure, the technician should suspect what?

• A. Infection at needle site
• B. Allergic reaction
• C. Infiltration
• D. Clotting of needle

Answer: (C)

Pain at the venous needle site with distal swelling and rising venous pressure points to infiltration. When the needle tip isn’t fully in the vein or the vein is injured, blood can leak into the surrounding tissue. This causes pain at the insertion site and swelling downstream from the needle as tissue becomes edematous. The dialysis circuit then experiences backpressure as return flow is obstructed, leading to rising venous pressure on the machine.

This pattern isn’t typical of infection (which would present with warmth, redness, possible fever), an allergic reaction (itching, hives, respiratory symptoms), or a clotting issue with the needle (which usually alters flow differently and isn’t characterized by distal swelling from extravasated blood).