A 40-year-old patient with polycystic kidney disease is scheduled to receive a kidney transplant.

When the nurse begins to administer 2 units of leukocyte-poor packed red blood cells to treat a low hemoglobin level, the patient asks why this has been prescribed.

What is the appropriate response from the nurse?

Choice A rationale:
Elevate the head of the bed to 35-45 degrees unless contraindicated:
Promotes venous return: Elevating the head of the bed reduces venous pooling in the lower extremities and promotes venous return to the heart. This helps to improve cardiac output and reduce the risk of fluid overload.
Reduces aspiration risk: Elevating the head of the bed also helps to prevent aspiration, as it keeps the head and neck in a more upright position. This allows for better drainage of secretions and reduces the chance of them entering the lungs.
Contraindications: There are a few contraindications to elevating the head of the bed, such as severe hypotension, head injury, or spinal injury. In these cases, the potential benefits of elevation must be weighed against the risks.
Choice B rationale:
Assess Vital Signs:
Baseline assessment: It's crucial to obtain baseline vital signs before administering any IV fluid to have a reference point for comparison. This allows for early detection of any changes that may indicate fluid overload or other complications.
Monitoring fluid status: Vital signs, including blood pressure, heart rate, respiratory rate, and temperature, provide important information about the patient's fluid status and hemodynamic stability. Changes in vital signs can signal fluid overload, dehydration, or other problems that may require intervention.
Detecting adverse reactions: Vital signs can also help to detect adverse reactions to the IV fluid, such as allergic reactions or anaphylaxis. Early identification of these reactions is essential for prompt treatment.
Choice D rationale:
Assess lung and heart sounds:
Baseline assessment: Assessing lung and heart sounds before IV fluid administration provides a baseline for comparison and helps to identify any preexisting conditions that may affect fluid tolerance.
Detecting fluid overload: Crackles in the lungs, increased heart rate, and extra heart sounds can indicate fluid overload, which can lead to pulmonary edema and heart failure.
Monitoring response to therapy: Lung and heart sounds can also be used to monitor the patient's response to IV fluid therapy. Improvement in lung sounds and heart rate can indicate a positive response to treatment.
Choice E rationale:
Obtain baseline weight:
Accurate fluid balance: Obtaining a baseline weight is essential for accurate assessment of fluid balance. It allows for tracking of fluid gains and losses and helps to prevent fluid overload or dehydration.
Monitoring fluid status: Changes in weight can reflect changes in fluid status. Weight gain can indicate fluid retention, while weight loss can suggest dehydration.

Choice A rationale:
Plague is a highly contagious and often fatal disease caused by the bacterium Yersinia pestis. It is transmitted to humans through the bites of infected fleas or by direct contact with infected animals or their tissues.
Plague can cause severe illness and death, even with prompt treatment. The mortality rate for untreated plague is 50-60%. Therefore, it is incorrect to state that plague produces a mild illness and generally has a low mortality rate.
Choice C rationale:
Smallpox is a highly contagious and deadly disease caused by the variola virus. It was eradicated in 1980, but there is still a risk that it could be used as a bioweapon.
Most people under the age of 40 have not been vaccinated against smallpox and therefore have no immunity to the disease. Therefore, it is incorrect to state that the majority of Americans have adequate innate immunity to smallpox.
Choice D rationale:
Safer food preparation practices have helped to decrease the incidence of foodborne illnesses.
However, foodborne illnesses can still be spread through international travel. Travelers can be exposed to contaminated food or water in other countries.

Therefore, safer food preparation practices do not eliminate the risk of foodborne illnesses being spread through international travel.