A nurse is preparing to give a client an infusion of packed red blood cells (PRBCS). The nurse is priming her administration IV tubing, the nurse primes one side of the Y tubing with the blood and the other should be which solution?

DSW

0.3% NS

Lactated Ringers

0.9% NS

Answer and Explanation

The Correct Answer is D

A) D5W: Dextrose 5% in water (D5W) is not used with blood transfusions because it can cause hemolysis of the red blood cells due to its hypotonic nature. It can also potentially cause clumping and clotting.

B) 0.3% NS: This is a hypotonic saline solution, which can lead to hemolysis of red blood cells when used as a diluent for blood products. It is not appropriate for use in blood transfusions.

C) Lactated Ringers: Although lactated Ringer's solution is often used for fluid resuscitation, it contains calcium, which can cause clotting in the blood product. Therefore, it is not suitable for use with blood transfusions.

D) 0.9% NS: Normal saline (0.9% sodium chloride) is isotonic and the only solution recommended for use with blood transfusions. It does not cause hemolysis of red blood cells, does not alter the composition of the blood product, and helps to maintain the patency of the IV line. It is the standard diluent used in blood transfusions to ensure the safe administration of blood products.

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Correct Answer is B

Explanation

A) Hyperactive bowel sounds: Hypercalcemia typically leads to decreased gastrointestinal motility, not increased. Clients with elevated calcium levels may experience constipation, abdominal pain, or ileus due to the relaxing effect of calcium on smooth muscle. Therefore, hyperactive bowel sounds are not a common finding in hypercalcemia.

B) Increased blood clots: Hypercalcemia can promote a hypercoagulable state, increasing the risk of thromboembolic events. This occurs because high calcium levels can enhance platelet aggregation and increase the coagulability of blood. Therefore, a client with elevated serum calcium may have an increased risk of developing blood clots.

C) Hyperactive deep tendon reflexes: Hypercalcemia generally leads to reduced neuromuscular excitability, which may manifest as decreased or absent deep tendon reflexes, muscle weakness, and lethargy. Hyperactive reflexes are more commonly associated with hypocalcemia, which causes increased neuromuscular excitability.

D) Positive Chvostek’s sign: Chvostek's sign is a clinical indicator of hypocalcemia, not hypercalcemia. It involves twitching of the facial muscles in response to tapping the facial nerve and is due to increased neuromuscular excitability caused by low calcium levels. Hypercalcemia, conversely, does not typically present with a positive Chvostek’s sign.

A. Discontinue cardiac monitoring during the infusion. B. Administer KCI as a rapid IV bolus. C. Only give the KCI via a central venous line. D. Infuse the KCI at a rate of 10 mEq/hour.

Correct Answer is C

Explanation

A) Discontinue cardiac monitoring during the infusion:

Discontinuing cardiac monitoring during the infusion of potassium chloride is unsafe. Potassium infusions can significantly impact cardiac function, so continuous cardiac monitoring is necessary to detect any arrhythmias or other complications.

B) Administer KCI as a rapid IV bolus:

Administering potassium chloride as a rapid IV bolus is contraindicated due to the risk of severe adverse effects, including cardiac arrest. Potassium should be infused slowly to avoid complications.

C) Only give the KCI via a central venous line:

Potassium chloride is ideally administered through a central venous line because it is irritating to veins and can cause damage if given through a peripheral line. A central line reduces the risk of irritation and allows for safer infusion of potassium.

D) Infuse the KCI at a rate of 10 mEq/hour:

Infusing potassium chloride at a rate of 10 mEq/hour is generally too slow for an emergency situation requiring immediate correction of severe hypokalemia. For more urgent cases, higher rates may be required, but only under strict medical supervision to avoid complications.

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A nurse is preparing to give a client an infusion of packed red blood cells (PRBCS). The nurse is priming her administration IV tubing, the nurse primes one side of the Y tubing with the blood and the other should be which solution?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Explanation

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