The nurse has reviewed the Nurses' Notes, Vital Signs, and Laboratory Results from 3 months ago.

Exhibits

The nurse is reviewing the client's plan of care. Which of the following findings indicate the client's condition has improved? Select all that apply.

Rationale:

A. Insert a large-bore IV catheter: A large-bore (18–20 gauge) IV catheter is required to allow rapid infusion of blood products if needed, minimizing hemolysis and ensuring adequate flow. This is critical for the safety and effectiveness of the transfusion, especially in clients who may be hemodynamically unstable.

B. Witness the client signing a consent for transfusion: Obtaining informed consent ensures the client understands the risks, benefits, and alternatives to the blood transfusion. Witnessing the signature is a legal and ethical requirement to confirm that the client has voluntarily agreed to the procedure.

C. Have a second nurse confirm the information on the blood label: Verification by a second nurse prevents administration errors, such as giving the wrong blood type or unit. This double-check process is essential for patient safety and is standard protocol before starting a transfusion.

D. Flush the transfusion tubing with dextrose 5 in water: Blood products should not be administered through tubing flushed with dextrose solutions because dextrose can cause red blood cell hemolysis. Normal saline is the only appropriate solution for priming and flushing blood administration tubing.

E. Explain to the client that transfusion reactions are not serious: Transfusion reactions can be life-threatening, including hemolytic, allergic, or febrile reactions. Minimizing the seriousness of these risks is inappropriate; the client should be informed about potential complications and instructed to report any symptoms immediately.

Rationale:

A. Have teachers and school personnel model healthy eating behaviors: Children learn through observation, and consistent modeling by adults reinforces healthy habits in daily routines. When teachers demonstrate balanced meal choices, students are more likely to adopt similar behaviors. This strategy promotes a supportive environment that normalizes nutritious eating across the school.

B. Recommend removing complex carbohydrate snacks from school vending machines: Complex carbohydrates such as whole-grain items provide sustained energy and support healthy growth. Removing them could encourage replacement with less nutritious options. The goal is to limit high-sugar, high-fat snacks, not to eliminate nutrient-dense foods that benefit the child’s diet.

C. Provide fruits and vegetables as snacks at school sporting events: Offering fresh produce at athletic activities increases children's access to nutritious options during high-energy events. It helps shift the culture away from sugary snacks typically sold at sports venues. This approach supports hydration, recovery, and overall health maintenance in active students.

D. Assist students in developing a recipe book of healthy foods: Engaging children in creating a recipe book encourages active learning and empowers them to make informed food choices. It integrates nutrition education with creativity and helps students build long-term healthy eating skills. Sharing the book can also influence families and the wider community.

E. Offer a dessert to students who finish their lunch: Providing dessert as a reward reinforces unhealthy associations with food and promotes overeating. It teaches children to view sweets as a prize rather than an occasional treat. This approach undermines efforts to build healthy eating patterns and may contribute to long-term poor dietary habits.