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Chapter 34: Problem 50

A nurse has an order to administer packed red blood cells to a client. Prior to administration, the nurse should (check all that apply): ___ obtain consent ___ gather IV tubing with a filter ___ gather D5 1?2 NS ___ prime the line with fluid ___ check the blood with either an RN or LPN ___ warm the blood to \(100^{\circ} \mathrm{F}\) ___ assess the site for patency

Short Answer

Expert verified
Obtain consent, gather IV tubing with a filter, prime the line with fluid, check the blood with another nurse, and assess the site for patency.

Step by step solution

01

- Obtain Consent

Before administering packed red blood cells (PRBCs), it's essential to obtain informed consent from the client. This involves explaining the procedure, potential risks, and benefits.
02

- Gather IV Tubing with a Filter

Obtain the appropriate IV tubing that includes a filter. The filter helps catch clots and other debris.
03

- Prime the Line with Fluid

Prime the IV line with normal saline (0.9% NaCl), as this is the only compatible fluid with blood products. Do not use dextrose solutions like D5 1/2 NS.
04

- Check the Blood with Another Nurse

Check the blood product with another RN or LPN to verify the right blood product is being administered. This includes checking the client's identity, the blood unit number, and expiration date.
05

- Assess the Site for Patency

Ensure that the IV site is patent (functioning properly) to allow for the smooth administration of the PRBCs.

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Key Concepts

These are the key concepts you need to understand to accurately answer the question.

Nursing Checklist
Before starting a blood transfusion, nurses must follow a comprehensive checklist. This ensures patient safety and compliance with medical standards. Here鈥檚 an overview of the key items to check:
  • Obtain consent from the patient.
  • Gather necessary supplies like IV tubing with a filter.
  • Prime the IV line properly, using normal saline.
  • Verify blood details with another nurse.
  • Check the IV site for patency.
Each step is vital for a safe and effective transfusion.
IV Tubing with Filter
For blood transfusions, specific IV tubing with a filter is necessary. Filters play a crucial role by:
  • Removing clots that could form during storage.
  • Filtering out debris which could cause complications.
Make sure the tubing is suitable for blood products and properly attached to the IV setup. Always verify the presence of an integrated filter before proceeding.
Patient Consent
Informed consent is a crucial step before any medical procedure, including blood transfusions. Explain the procedure to the patient clearly, covering:
  • Purpose of the transfusion and expected benefits.
  • Potential risks, such as allergic reactions or infections.
  • Alternative options if available.
The patient should have an opportunity to ask questions. Document their consent in the medical record.
Normal Saline for Priming
When priming the IV line, only use normal saline (0.9% NaCl). It鈥檚 the only fluid compatible with blood products. Using other solutions like D5 1/2 NS can cause hemolysis (destruction of red blood cells).
  • Attach the saline bag to the IV line.
  • Prime the tubing by allowing saline to flush all air out.
This step ensures the blood can flow smoothly and safely.
Verification Procedures
Prior to transfusion, verify the blood product carefully. This should be done with another nurse to avoid errors.
  • Check the patient鈥檚 identity against the blood unit.
  • Verify the blood unit number and expiration date.
  • Ensure compatibility with the patient鈥檚 blood type.
Double-checking these details prevents mismatched transfusions which could lead to serious reactions.
IV Site Patency
Before administering blood, the IV site must be patent, meaning it should be free-flowing and properly positioned.
  • Inspect the site for redness or swelling.
  • Ensure there is good blood flow by flushing the IV line with saline.
A patent IV site ensures that the transfusion can be delivered effectively and reduces the risk of complications.

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Most popular questions from this chapter

A 15-year-old boy was admitted to the pediatric unit following an injury to his leg. When told that the complicated fracture would require surgical repair and prevent a return to the football team for an unknown extended period of time, the boy throws an apple from the lunch tray at the nurse. Which type of coping behavior is the teenager exhibiting? A. Reaction formation B. Projection C. Denial D. Displacement

The nurse is comparing laboratory results on admission with laboratory results following treatment of a client with DIC. Which change in laboratory values from admission indicates a positive response to therapy? A. Decrease in platelet count B. Increase in fibrinogen level C. D-dimer assay increase D. Decreased bleeding time

A pregnant woman at term comes to the labor unit saying her membranes have ruptured. Which characteristic of the client's vaginal secretions would confirm that the membranes had ruptured? The vaginal secretions: A. Are positive for glucose B. Contain red blood cells C. Turn nitrazine paper a reddish orange D. Appear fern like under the microscope when dried on a slide.

An industrial nurse responds to an emergency in the plant where a worker is burned. Which is the correct sequence of nursing actions? A. Eliminate the source of the burn, ensure airway patency, observe for and treat associated injuries, treat burn shock. B. Eliminate the source of the burn, ensue airway patency, cool the burn wound, apply topical antibiotic cream. C. Ensure airway patency, insert a nasogastric tube, insert a bladder catheter, stare IV fluid infusion. D. Treat burn shock, ensure airway patency, start IV antibiotics and put the client in reverse isolation.

A mother asks the nurse when she should begin toilet training her toddler. Which is an appropriate response for the nurse to give? An indication that a child is ready to begin toilet training is that the child A. pulls on the diaper when it is wet. B. has a BM at the same time every day. C. doesn鈥檛 want to lay down for diaper changes. D. hides behind the living room chair when having a BM
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