A nurse is preparing to administer an infusion of packed RBCs through a peripheral IV catheter. Which of the following actions should the nurse take?

Prime the IV tubing with lactated Ringer's.

Use a 24-gauge IV catheter for the transfusion.

Ensure that the IV tubing has an in-line filter.

Prepare to change the tubing at least every 2 hr.

Answer and Explanation

The Correct Answer is C

A. Prime the IV tubing with lactated Ringer's. Blood products should only be primed with 0.9% sodium chloride (normal saline) because other solutions (e.g., lactated Ringer's or dextrose solutions) can cause hemolysis.
B. Use a 24-gauge IV catheter for the transfusion. A 24-gauge catheter is too small for a blood transfusion and may cause hemolysis or slow infusion. A large-bore catheter (18–20 gauge) is recommended for optimal flow.
C. Ensure that the IV tubing has an in-line filter. An in-line filter helps remove clots and debris, reducing the risk of transfusion reactions.
D. Prepare to change the tubing at least every 2 hr. Blood tubing should typically be changed after 4 hours or after two units of blood, whichever comes first, to prevent bacterial contamination.

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Correct Answer is B

Explanation

A. "Place the head of the bed flat before using the incentive spirometer." The client should be in a semi-Fowler’s or high-Fowler’s position (sitting upright) to maximize lung expansion.
B. "Hold your breath for 2 to 3 seconds when using the incentive spirometer." Holding the breath allows for maximum lung expansion and helps prevent atelectasis (lung collapse).
C. "Use the incentive spirometer every 3 hours while awake." The incentive spirometer should be used every 1 to 2 hours while awake to promote lung expansion and prevent complications such as pneumonia.
D. "Breathe in through your nose when using the incentive spirometer." The client should inhale deeply through the mouth, not the nose, to ensure proper lung inflation.

A. Grasps the catheter 10.16 to 12.7 cm (4 to 5 in) from the tip B. Cleanses the meatus using a clean cotton ball C. Cleanses the meatus from the center in a circular motion D. Applies clean gloves before beginning the procedure

Correct Answer is C

Explanation

A. Grasps the catheter 10.16 to 12.7 cm (4 to 5 in) from the tip The catheter should be held at least 5 to 7.6 cm (2 to 3 inches) from the tip to maintain better control and prevent contamination.
B. Cleanses the meatus using a clean cotton ball Aseptic technique requires a separate antiseptic swab or cotton ball for each stroke to avoid introducing bacteria.
C. Cleanses the meatus from the center in a circular motion Cleaning from the center outward prevents introducing bacteria into the urethra, which is essential for infection prevention.
D. Applies clean gloves before beginning the procedure Sterile gloves, not clean gloves, must be used during catheterization to maintain aseptic technique.

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A nurse is preparing to administer an infusion of packed RBCs through a peripheral IV catheter. Which of the following actions should the nurse take?

Nursing Test Bank

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