A nurse is preparing to initiate a transfusion of packed RBC for a patient who has anemia. Which of the following actions should the plan to nurse take?

Infuse the transfusion at a rate of 200 mL/hr.

Check the patient's vital signs every hour during the transfusion.

Leave the patient 5 minutes after beginning the transfusion.

Flush the blood tubing with dextrose 5% in water.

Answer and Explanation

The Correct Answer is B

A. Infuse the transfusion at a rate of 200 mL/hr. – Incorrect. The initial infusion should be slow (e.g., 75-100 mL/hr) to monitor for reactions.

B. Check the patient's vital signs every hour during the transfusion. – Correct Answer. Frequent monitoring is necessary to detect adverse reactions, such as fever or hypotension.

C. Leave the patient 5 minutes after beginning the transfusion. – Incorrect. The nurse should remain with the patient for the first 15 minutes, as most transfusion reactions occur early.

D. Flush the blood tubing with dextrose 5% in water. – Incorrect. Only normal saline should be used to flush blood tubing, as dextrose can cause hemolysis.

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Correct Answer is D

Explanation

A. High fever. – Incorrect. Fever can occur with infection but is not a hallmark sign of sickle cell crisis.

B. Constipation. – Incorrect. Constipation is not a defining symptom of sickle cell crisis.

C. Bradycardia. – Incorrect. Tachycardia, not bradycardia, is common due to pain and hypoxia.

D. Pain. – Correct Answer. Severe pain is the most common symptom of sickle cell crisis due to vaso-occlusion and ischemia.

A. Double-check the product numbers on the PRBCS with the patient ID band. B. Monitor the patient for shortness of breath or chest pain during the transfusion. C. Obtain the temperature, blood pressure, and pulse before the transfusion. D. Verify the patient identification (ID) according to hospital policy.

Correct Answer is C

Explanation

A. Incorrect. Blood verification must be done by two licensed nurses.

B. Incorrect. Monitoring for transfusion reactions is the nurse's responsibility.

C. Correct. UAPs can obtain baseline vital signs before the transfusion, as long as the nurse interprets them.

D. Incorrect. Verifying patient ID for blood transfusions is a nursing responsibility per hospital protocol.

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A nurse is preparing to initiate a transfusion of packed RBC for a patient who has anemia. Which of the following actions should the plan to nurse take?

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