What is a key sign of phlebitis in a patient receiving IV vancomycin?

A key sign of phlebitis in a patient receiving IV vancomycin is the presence of pain and swelling at the IV site. Phlebitis refers to the inflammation of a vein, which can occur as a result of the irritation caused by the intravenous administration of medications like vancomycin. This inflammation often manifests as localized symptoms, including tenderness, redness, swelling, and warmth around the IV site. These are direct indicators that the vein is reacting negatively to the infusion, potentially due to chemical irritation or infection.

In contrast, elevated white blood cell count, cyanosis in the limb receiving IV fluids, and fever above 101°F may suggest other underlying issues such as infection, systemic inflammatory response, or complications unrelated to phlebitis. While systemic signs like fever could indicate an infection, the hallmark symptoms of phlebitis remain localized to the IV site, making pain and swelling the most immediate and relevant indicators in this context.