A nurse is caring for a client with an order for one unit of packed red blood cells (PRBCs). The nurse should anticipate to remain ate client's bedside during which time period of the infusion?
The first 2 min
The final 15 min
The first 15 min
The final 2 min
The Correct Answer is C
A) The first 2 min: While it is essential to monitor the client closely during the first few minutes of a PRBC infusion, a two-minute observation period is insufficient to detect most acute transfusion reactions. Many reactions, such as fever, chills, and allergic responses, can take longer to manifest.
B) The final 15 min: Monitoring during the final 15 minutes is important to ensure the infusion is completed without complications. However, the most critical time for monitoring is at the beginning of the infusion, as acute reactions are more likely to occur early on.
C) The first 15 min: The first 15 minutes of a PRBC transfusion are crucial because most acute transfusion reactions, such as allergic reactions, febrile non-hemolytic reactions, and hemolytic reactions, occur within this time frame. The nurse should remain at the bedside to promptly identify and manage any adverse reactions, ensuring the client's safety.
D) The final 2 min: Monitoring during the final two minutes of the infusion is also important, but it is not the critical time frame for detecting most transfusion reactions. Observing the client closely during the initial phase of the transfusion is essential to address any immediate complications.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. 8 hr - Infusing one unit of packed red blood cells (PRBCs) over 8 hours is too long. Typically, PRBCs are infused over a shorter period to avoid complications.
B. 4 hr - Infusing PRBCs over 4 hours is still within acceptable limits, but the standard time for PRBC transfusion is usually shorter.
C. 6 hr - Infusing PRBCs over 6 hours is longer than usual. The recommended duration for infusing one unit of PRBCs is generally shorter.
D. 2 hr - The standard time to infuse one unit of PRBCs is typically between 1.5 to 2 hours. This duration helps ensure the effective delivery of red blood cells while minimizing the risk of transfusion reactions.
Correct Answer is C
Explanation
A) Cooked carrots: While cooked carrots do contain some potassium, they are not as rich in potassium as other foods. They are a good source of vitamins and nutrients, but not the most effective option for replenishing potassium levels.
B) Cheddar cheese: Cheese generally contains minimal potassium compared to other foods. It is a good source of calcium and protein, but it is not a significant source of potassium. Individuals on loop diuretics like furosemide, which can cause potassium loss, need to consume foods higher in potassium.
C) Baked potato: Baked potatoes are an excellent source of potassium. A medium-sized baked potato with the skin can provide a significant amount of potassium, which is essential for maintaining normal heart function and muscle contraction. This makes it an ideal food choice for clients on diuretics like furosemide, which can deplete potassium levels.
D) 2% milk: While milk contains potassium, it is not as high in potassium as other foods, like fruits and vegetables. Although it can contribute to daily potassium intake, it is not the most potent source for clients needing to increase their potassium levels due to diuretic use.
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