A nurse is caring for a client who has pneumonia caused by Heemophilus influenzae type B. Which of the following types of isolation precautions should the nurse implement?

A. Administer the unit of packed RBCs over 1 hr: Transfusing packed RBCs too quickly increases the risk of fluid overload and cardiovascular complications. Standard practice is to administer the unit over 2 to 4 hours, with careful monitoring for adverse reactions.

B. Obtain the client's first set of vital signs 1 hr after initiating the transfusion: Vital signs should be obtained immediately before starting the transfusion, then monitored closely during the first 15 minutes, when most acute transfusion reactions occur. Waiting an hour could delay recognition of complications.

C. Use Y tubing with 0.9% sodium chloride when administering the transfusion: Y tubing with normal saline is the correct method for administering packed RBCs. Saline maintains patency of the line and prevents incompatibility reactions, as other IV solutions can cause hemolysis or chemical reactions with the blood product.

D. Initiate venous access with a 21-gauge needle: A 21-gauge needle is too small for safe administration of packed RBCs, as it can cause hemolysis. A larger gauge needle, typically 18–20 gauge, is recommended to ensure smooth transfusion and minimize cell damage.

A. "Perform CPR while the AED is analyzing": The AED must analyze the heart rhythm without interference. Performing CPR during analysis can prevent the device from accurately detecting a shockable rhythm, so the nurse should instruct to pause CPR while the AED evaluates the client.

B. "Use an AED for a client who has atrial fibrillation.": AEDs are not indicated for atrial fibrillation unless it degenerates into a pulseless ventricular arrhythmia. AEDs are designed for sudden cardiac arrest due to ventricular fibrillation or pulseless ventricular tachycardia, not for non-life-threatening arrhythmias.

C. "Position the client on a flat surface.": Placing the client on a firm, flat surface ensures effective chest compressions and proper contact of AED pads with the chest. This positioning is critical for both CPR efficacy and accurate AED analysis.

D. "Set the AED to 80 joules.": Modern AEDs are automatic and preprogrammed to deliver the appropriate energy level. Users should not manually set joules, as the device determines the correct shock dose for safety and effectiveness.