A nurse is preparing to transfuse one unit of packed RBC to a client who experienced a mild allergic reaction during a previous transfusion. The nurse should administer diphenhydramine prior to the transfusion for which of the following allergic responses?
Hemolysis
Urticaria
Fever
Fluid overload
The Correct Answer is B
A. Hemolysis: This is a severe reaction to blood transfusion involving the destruction of red blood cells and requires different management strategies.
B. Urticaria: Diphenhydramine is used to prevent or treat urticaria (hives), which is a mild allergic reaction and can be managed with antihistamines.
C. Fever: This is typically managed with antipyretics or by addressing the underlying cause rather than antihistamines.
D. Fluid overload: This condition requires management with diuretics and careful monitoring of fluid intake rather than antihistamines.
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Related Questions
Correct Answer is A
Explanation
A. Administer the medication using a Z-track technique: This is correct as ceftriaxone should be administered using the Z-track technique to prevent leakage of the medication into the subcutaneous tissue and minimize irritation.
B. Administer the medication using a 5/8-inch needle: A longer needle is typically needed for IM injections to reach the muscle tissue, so a 5/8-inch needle is not appropriate.
C. Administer the medication in the deltoid muscle: Ceftriaxone is usually administered in the larger muscle groups such as the ventrogluteal or vastus lateralis muscles rather than the deltoid.
D. Administer the medication at a 45° angle: IM injections are generally given at a 90° angle to ensure that the medication is properly deposited into the muscle tissue.
Correct Answer is A
Explanation
A. Specific characteristics of the medications: This is correct. The primary consideration for determining the medication schedule is the specific characteristics of each medication, including its pharmacokinetics, such as how often it should be administered and whether it needs to be taken with food or at certain times of the day.
B. Time at which the medication can be available from the pharmacy: While this may affect the timing of administration, it is not the primary factor. Medications should be scheduled based on their specific requirements for effectiveness and safety, regardless of pharmacy availability.
C. Institutional policies regarding routine medication administration times: Although institutional policies may provide guidelines for routine administration, they should be adjusted based on the specific needs of the medication and the client.
D. Schedule of administration that the client follows at home: While this may be relevant for maintaining continuity of care, the primary factor in determining the administration schedule should be the specific characteristics and requirements of the medications themselves.
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