A nurse in a provider's office is caring for a client who has asthma and reports that the manifestations get worse while exercising. Which of the following statements should the nurse make?

Rationale:

• Titrate the rate of infusion to maintain the client's blood pressure at least 90/60 mm Hg: The nurse should follow the ordered transfusion rate and not titrate it based on blood pressure. The priority is to transfuse the blood safely and at the prescribed rate, while monitoring the client's response. Blood pressure will improve as the blood volume is restored.
• Obtain the first unit of packed RBCs from the blood bank: This is necessary to correct the client’s anemia (Hgb 9.1 g/dL, Hct 27%) and address the suspected acute blood loss indicated by positive hemoccult stool and hemodynamic changes.
• Document the blood product transfusion in the client's medical record: Accurate documentation ensures legal compliance, tracks the administration, and records the client’s response, including any adverse events, supporting continuity of care.
• Stay with the client for the first 15 min of the transfusion: Most transfusion reactions occur during the first 15 minutes. Close observation allows for immediate intervention if the client develops fever, hypotension, or other adverse effects.

• Start an IV bolus of lactated Ringer's solution: Lactated Ringer’s contains calcium which can cause clotting in the transfusion line. Using LR can lead to hemolysis or transfusion complications. Only 0.9% sodium chloride should be used for flushing or running alongside blood transfusions.

Rationale:

A. "The nurse will ask you to remove any transdermal patches prior to the procedure.": Some transdermal patches contain metallic components that can overheat during an MRI, posing a burn risk. Removing them prevents injury and ensures safety in the strong magnetic field.

B. "The nurse will ask you to wear protective eyewear during this procedure.": Protective eyewear is not necessary for MRI scans, as there is no exposure to bright light or flying debris. This precaution applies more to procedures involving lasers or potential eye hazards.

C. "You should not have this procedure if you are allergic to iodine.": Iodine allergies are a concern with certain CT scans using iodinated contrast, not standard MRIs. MRI contrast agents typically contain gadolinium, which has a different allergy profile.

D. "You should not have this procedure if you have a tattoo.": Tattoos generally do not contraindicate MRI, although some with metallic ink may cause mild skin irritation. This is rare and does not usually prevent the procedure from being performed.