A nurse is preparing to administer 2 units of packed RBCs to a client.

Which of the following actions should the nurse take?

Transfuse each unit of blood over 5 hr.

Change the IV tubing after each unit of blood is transfused.

Prime the tubing with 0.9% sodium chloride.

Administer the blood through a 22-gauge intravenous catheter.

Answer and Explanation

The Correct Answer is C

When administering packed RBCs, the tubing should be primed with 0.9% sodium chloride.
Transfusing each unit of blood over 5 hours (choice A) is not recommended as it may increase the risk of bacterial growth.
Packed RBCs should be transfused over 2 to 3 hours.
Changing the IV tubing after each unit of blood is transfused (choice B) is not necessary.
Administering the blood through a 22-gauge intravenous catheter (choice D) may not be appropriate as a larger gauge catheter is typically used for blood transfusions.

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Correct Answer is C

Explanation

Applying an ice pack can help reduce pain and swelling after total knee arthroplasty.
Placing pillows under the client’s knee (choice A) is not recommended as it can hinder circulation and delay healing.
Performing range-of-motion exercises to the client’s knee (choice B) may be part of the rehabilitation process but should be done under the guidance of a physical therapist and may not be appropriate for immediate pain relief.
Gently massaging the area around the client’s incision (choice D) may not be appropriate as it can cause discomfort and disrupt the healing process.

A. Check the infusion site at least every 4 hr. B. Start the infusion at 30 mEq/hr. C. Assess the client for a positive Chvostek sign. D. Monitor the client for adequate urine output.

Correct Answer is D

Explanation

Monitor the client for adequate urine output.
When administering potassium chloride via IV infusion to a client who has severe hypokalemia, it is important for the nurse to monitor the client’s urine output to ensure that their kidneys are functioning properly and that they are able to excrete excess potassium.
Choice A is incorrect because the infusion site should be checked more frequently than every 4 hours.
Choice B is incorrect because the maximum recommended rate of infusion for potassium chloride is 10 mEq/hr.
Choice C is incorrect because Chvostek’s sign is used to assess for hypocalcemia, not hypokalemia.

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A nurse is preparing to administer 2 units of packed RBCs to a client. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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A nurse is preparing to administer 2 units of packed RBCs to a client.

Which of the following actions should the nurse take?