A nurse is caring for a client who is to receive a unit of packed RBCs. The nurse should prime the blood administration tubing using which of the following IV solutions?

Choice A reason: Weighing the client is not a necessary action before administering digoxin, as it does not affect the dosage or effectiveness of the medication. Weighing the client may be important for monitoring fluid balance and edema, but it is not related to digoxin therapy.

Choice B reason: Measuring the client's blood pressure is not a necessary action before administering digoxin, as it does not affect the dosage or effectiveness of the medication. Digoxin is not a blood pressure-lowering medication, but a cardiac glycoside that increases the contractility and efficiency of the heart. Measuring the blood pressure may be important for monitoring hypertension, but it is not related to digoxin therapy.

Choice C reason: Measuring the client's apical pulse is a necessary action before administering digoxin, as it can help determine the safety and appropriateness of the medication. Digoxin can cause bradycardia (slow heart rate) as a side effect, which can be dangerous and symptomatic. The nurse should check the apical pulse for one full minute and withhold the medication if the pulse is below 60 beats per minute or above 100 beats per minute. The nurse should also report any abnormal or irregular rhythms to the provider.

Choice D reason: Offering the client a light snack is not a necessary action before administering digoxin, as it does not affect the absorption or effectiveness of the medication. Digoxin can be taken with or without food. Offering the client a light snack may be important for maintaining nutrition and hydration, but it is not related to digoxin therapy.

Choice A reason: The nurse collects a urine specimen is an appropriate action, as it can help detect the presence of hemoglobinuria, which is a sign of hemolysis. Hemoglobinuria is the excretion of hemoglobin in the urine, which can cause the urine to appear red or brown.

Choice B reason: The nurse sends a blood specimen to the laboratory is an appropriate action, as it can help confirm the diagnosis of a hemolytic reaction and identify the cause. The laboratory can perform tests such as blood typing, cross-matching, direct antiglobulin test (DAT), and serum bilirubin.

Choice C reason: The nurse initiates an infusion of 0.9% sodium chloride is an appropriate action, as it can help maintain the client's fluid and electrolyte balance and prevent hypovolemic shock. 0.9% sodium chloride is the preferred solution for blood transfusion reactions, as it is isotonic and compatible with blood products.

Choice D reason: The nurse starts the transfusion of another unit of blood product is an inappropriate action, as it can worsen the client's condition and increase the risk of complications. The nurse should not resume the transfusion until the cause of the reaction is determined and the provider orders a new unit of blood product. The nurse should also return the unused blood product and tubing to the blood bank for analysis.