A client is about to receive a blood transfusion, and the nurse is responsible for monitoring the transfusion.
What should the nurse do during the transfusion?

Choice A rationale:

Whole blood.

Rationale: Whole blood contains red blood cells, plasma, platelets, and clotting factors.

While it can increase fibrinogen levels, it also contains other components that may not be necessary for a patient with hemophilia A.

Fresh frozen plasma (FFP) is a more specific choice for increasing fibrinogen levels.

Choice B rationale:

Packed red blood cells (PRBCs)

Rationale: PRBCs primarily consist of red blood cells and are not a suitable choice for increasing fibrinogen levels.

Hemophilia A is a clotting disorder, and fibrinogen is a clotting factor found in plasma.

PRBCs do not contain significant amounts of plasma or clotting factors.

Choice C rationale:

Fresh frozen plasma (FFP)

Rationale: FFP is the most suitable choice for increasing fibrinogen levels in a patient with hemophilia A.

FFP contains all the clotting factors, including fibrinogen, and can help correct coagulation abnormalities in these patients.

Choice D rationale:

Platelets.

Rationale: Platelets are involved in the clotting process, but they do not contain significant amounts of fibrinogen.

Platelets are used to treat conditions where there is a deficiency in platelet count or function, not to increase fibrinogen levels.

"I'll stay with the patient for the entire transfusion."

Choice A rationale:

Staying with the patient for the entire transfusion is a crucial safety measure.

The nurse must monitor the patient for any signs of a transfusion reaction, such as fever, chills, rash, shortness of breath, or changes in vital signs.

Immediate intervention may be required if a reaction occurs.

Choice B rationale:

Adding medications to the blood bag is not within the nurse's scope of practice and should not be done without a specific physician's order.

Medications should be administered separately through a different IV line, if necessary, and only as ordered.

Choice C rationale:

Administering the transfusion at a rate of 4 mL/min is not a standard practice.

The rate of transfusion is determined by the physician's order and the patient's specific needs.

It is not a fixed rate and should be adjusted as needed.

Choice D rationale:

Using any available intravenous line for the transfusion may not be appropriate, especially if the line is already in use for other medications or fluids.

The nurse should select a dedicated line for the transfusion to minimize the risk of contamination or complications.