A nurse is caring for a client with numerous episodes of watery diarrhea. The client reports eating some spoiled deli meat earlier in the day. The client asks if they should take loperamide (Imodium) to stop the diarrhea. What would be an appropriate response from the nurse?

Choice A Reason:

Retrieving the blood from the laboratory and running each unit at an 8-hour rate is not appropriate. According to transfusion guidelines, blood products should be infused within 4 hours to prevent bacterial growth and reduce the risk of transfusion-related complications1. Infusing blood over 8 hours increases the risk of these complications.

Choice B Reason:

Notifying the laboratory to split the unit into 2 and then infusing each half for 4 hours is also not ideal. While this approach might seem to address the time constraint, it is not a standard practice and could lead to issues with blood product integrity and patient safety2. Blood products are typically not split unless there are specific protocols in place, and this is not a common intervention for managing infusion rates.

Choice C Reason:

Calling the HCP to question the order is the correct intervention. Blood transfusions must be completed within 4 hours to ensure patient safety and maintain the integrity of the blood product3. The nurse should advocate for the patient by questioning any orders that do not align with established guidelines and best practices.

Choice D Reason:

Infusing each unit for 8 hours is incorrect. The maximum duration for infusing a unit of blood is 4 hours4. Extending the infusion time beyond this limit increases the risk of complications such as bacterial contamination and reduced efficacy of the blood product.

Choice A reason: To provide a means for medication administration

A Jackson-Pratt (JP) drain is not used for medication administration. Its primary function is to remove fluids that accumulate in a surgical site, which helps to prevent infection and promote healing. Medication administration is typically done through other means such as intravenous (IV) lines or oral medications.

Choice B reason: To eliminate the need for wound dressings

The JP drain does not eliminate the need for wound dressings. Dressings are still required to protect the wound site, absorb any additional drainage, and prevent infection. The JP drain works in conjunction with dressings to manage wound care effectively.

Choice C reason: To limit the amount of bleeding from the surgical site

While the JP drain can help manage bleeding by removing accumulated blood, its primary purpose is not to limit bleeding. Instead, it is designed to prevent the buildup of fluids, including blood, which can lead to complications such as hematomas or infections.

Choice D reason: To prevent fluid from accumulating in the wound

The primary purpose of a Jackson-Pratt (JP) drain is to prevent fluid from accumulating in the wound. This includes blood, lymphatic fluid, and other bodily fluids that can collect at the surgical site. By removing these fluids, the JP drain helps to reduce the risk of infection, promote healing, and decrease the likelihood of complications.