A nurse is planning care for a client who is scheduled to receive a transfusion of packed RBCs.
Which of the following actions should the nurse plan to take?

Store the unit of blood at room temperature for 1 hr prior to the infusion.

Ensure that the transfusion is completed within 6 hr.

Obtain venous access using a 22-gauge needle.

Use a solution of 0.9% sodium chloride to flush the transfusion tubing.

Answer and Explanation

The Correct Answer is D

The correct answer is D. Use a solution of 0.9% sodium chloride to flush the transfusion tubing.

Choice A reason: Storing a unit of blood at room temperature for 1 hour prior to the infusion is not recommended. Blood products should be kept refrigerated until just before the transfusion to minimize the risk of bacterial contamination. The recommended storage temperature for packed RBCs is 1-6°C. If blood is left at room temperature, it should be infused within 30 minutes to ensure safety.

Choice B reason: Ensuring that the transfusion is completed within 6 hours is not correct. The standard practice is to complete a blood transfusion over 2 to 4 hours, depending on the volume and the patient’s condition. This is to reduce the risk of bacterial growth and transfusion reactions. Prolonging the transfusion time beyond 4 hours increases the risk of bacterial contamination and can compromise the efficacy of the transfused red blood cells.

Choice C reason: Obtaining venous access using a 22-gauge needle is not ideal for a transfusion of packed RBCs. A larger bore needle, typically an 18-gauge or 20-gauge, is preferred to ensure adequate flow of the viscous packed RBCs and to prevent hemolysis. The smaller the gauge number, the larger the needle diameter, so a 22-gauge needle might be too small and could damage the red blood cells during the transfusion.

Choice D reason: Using a solution of 0.9% sodium chloride to flush the transfusion tubing is the correct action. Normal saline is isotonic and is the only fluid compatible with packed RBCs. It is used to prime the transfusion set and to flush the line before and after the transfusion to prevent hemolysis and clotting within the tubing.

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Correct Answer is A

Explanation

Choice A rationale:

Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) and can increase the risk of bleeding when used with warfarin, which is an anticoagulant medication. Combining these two medications can lead to excessive bleeding and is considered incompatible.

Choice B rationale:

Magnesium hydroxide is an antacid and does not have significant interactions with warfarin. It does not affect the anticoagulant properties of warfarin.

Choice C rationale:

Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor used to treat high blood pressure and heart failure. It does not have a significant interaction with warfarin.

Choice D rationale:

Propranolol is a beta-blocker used to treat high blood pressure, angina, and other heart conditions. It does not have a significant interaction with warfarin.

A. Previous violent behavior. B. Experiencing delusions. C. Male gender. D. A history of being in prison.

Correct Answer is A

Explanation

Choice A rationale:

Research consistently shows that individuals who have a history of violent behavior are at a higher risk of engaging in future violent acts. This is a significant predictor because past behavior is often indicative of future behavior. Individuals with a history of violence may have difficulty managing anger, frustration, or stress, making them more prone to aggressive tendencies in various situations.

Choice B rationale:

Experiencing delusions refers to having false beliefs that are firmly held despite evidence to the contrary. While delusions can lead to erratic behavior, not all individuals experiencing delusions will become violent. The presence of delusions alone is not as strong a predictor of future violence as a documented history of violent behavior.

Choice C rationale:

While statistical data may indicate that males are more commonly involved in violent crimes, it is important to note that gender alone is not a reliable predictor of an individual's likelihood to become violent. Many males never engage in violent behavior, and focusing solely on gender overlooks crucial individual factors that contribute to violent tendencies.

Choice D rationale:

Having a history of being in prison suggests past involvement in criminal activities, but it does not directly predict future violent behavior. Some individuals may have been incarcerated for non-violent offenses or may have undergone rehabilitation, reducing their propensity for violence. Therefore, this choice is not as strong a predictor as previous violent behavior.

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A nurse is planning care for a client who is scheduled to receive a transfusion of packed RBCs. Which of the following actions should the nurse plan to take?

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A nurse is planning care for a client who is scheduled to receive a transfusion of packed RBCs.
Which of the following actions should the nurse plan to take?