A nurse is providing teaching to a client who has a prescription for oxygen administration at home. Which of the following statements should the nurse include in the teaching?

Rationale:

A. Prime the infusion tubing with 0.45% sodium chloride.: Blood products should never be primed with hypotonic solutions like 0.45% sodium chloride because it can cause hemolysis of the RBCs. Only 0.9% sodium chloride (normal saline) is safe for priming and flushing blood administration tubing.

B. Assess the client's lung sounds prior to the infusion.: Older adults are at increased risk for fluid overload during transfusions. Assessing lung sounds before starting the infusion provides a baseline and helps detect early signs of pulmonary edema or transfusion-associated circulatory overload.

C. Verify with another nurse that the unit of blood is compatible with the client's blood type.: Performing a second verification with another nurse is a critical safety measure to prevent transfusion reactions. Confirming blood type and crossmatch ensures compatibility and patient safety.

D. Don sterile gloves to prepare the blood administration setup.: Sterile gloves are not required for blood administration. Standard clean technique with non-sterile gloves is sufficient to prevent infection, as the IV setup does not require sterility.

E. Infuse the blood over 4 hr.: Red blood cells should be infused within 4 hours to minimize the risk of bacterial growth and ensure product viability. Infusing too slowly can increase infection risk, and infusing too quickly can cause fluid overload, especially in older adults.

Rationale:

A. Instruct the client that this is due to increased salivary flow that occurs with aging: While aging can affect swallowing, persistent coughing specifically during meals suggests dysphagia or aspiration risk, not just increased saliva. Dismissing it as normal aging could delay necessary evaluation and intervention.

B. Encourage the client to increase fluid intake when the cough is present: Increasing fluids without assessing swallowing ability could worsen aspiration risk. Proper evaluation of swallowing mechanics is necessary before recommending fluid intake adjustments.

C. Recommend an antitussive 30 min prior to each meal: Suppressing the cough reflex can be dangerous in clients with swallowing difficulties, as the cough helps prevent aspiration. Using antitussives in this situation may increase the risk of choking or pneumonia.

D. Initiate a consultation with a speech-language pathologist: A speech-language pathologist can perform a swallowing assessment, identify aspiration risk, and recommend safe feeding strategies. Referral ensures proper evaluation and helps prevent complications such as aspiration pneumonia.