A nurse is assessing a client who is taking methamphetamines. Which of the following findings should the nurse identify as an adverse effect of methamphetamines?

Rationale for correct choices:

• Insert a large-bore IV catheter: A large-bore IV (18–20 gauge) is necessary to allow rapid administration of blood products and reduce hemolysis of red blood cells during transfusion. This ensures safe and effective delivery of the blood components.
• Witness the client signing a consent for transfusion: Informed consent is required before initiating a blood transfusion. The nurse ensures that the client understands the purpose, risks, and potential complications, and witnesses the signing to meet legal and ethical standards.
• Have a second nurse confirm the information on the blood lab: Verifying the blood type, crossmatch, and client identifiers with a second nurse reduces the risk of transfusion errors and ensures patient safety before starting the transfusion.

Rationale for incorrect choices:

• Explain to the client that transfusion reactions are not serious: Transfusion reactions can be serious, including hemolytic reactions, febrile reactions, or allergic responses. The nurse should educate the client on the potential risks and signs of a reaction rather than minimizing them.
• Flush the transfusion tubing with dextrose 5% in water: Blood products should only be administered with 0.9% sodium chloride (normal saline). Flushing with dextrose or other solutions can cause hemolysis and compromise the safety of the transfusion.

Rationale:

A. Choose high-fat cheese as a meat substitute: Cheese is an animal-derived product and not part of a vegan diet. Additionally, it is high in saturated fat, which can contribute to cardiovascular risk.

B. Choose foods high in vitamin B12: Vitamin B12 is primarily found in animal products, so vegans are at risk for deficiency. Including fortified foods or supplements helps prevent anemia and neurological complications.

C. Limit intake of foods high in vitamin C: Vitamin C-rich foods are beneficial for overall health and can improve non-heme iron absorption from plant sources. There is no reason to limit these foods in a vegan diet.

D. Limit intake of nuts and legumes: Nuts and legumes are excellent plant-based sources of protein, healthy fats, and micronutrients. Restricting them would reduce the nutritional adequacy of a vegan diet.