A nurse is preparing to administer packed RBCs to a client who has a low hemoglobin level. Which of the following actions should the nurse take prior to the start of the infusion?

A. Administer an antiemetic:

Administering an antiemetic might be necessary to relieve nausea and vomiting, but it is not the first action. Before administering medications, it is essential to assess the client's condition and gather information about the underlying cause of the symptoms.

B. Offer pain medication:

Offering pain medication is not the first action. The nurse needs to assess the client's condition, determine the cause of the pain, and gather more information before administering pain relief. Administering pain medication before a thorough assessment can mask important clinical signs and symptoms.

C. Palpate the abdomen:

Palpating the abdomen is an important step in the assessment, but it should follow auscultation of bowel sounds. Palpation can be deferred if there is concern about possible inflammation (as in suspected appendicitis) to avoid causing further irritation.

D. Auscultate bowel sounds:

This is the correct action. Auscultating bowel sounds is the first step in assessing the gastrointestinal (GI) function. The reported symptoms of right lower quadrant pain, nausea, and vomiting could be indicative of various GI issues, such as appendicitis. Assessing bowel sounds helps the nurse gather information about the status of peristalsis and potential obstructions.

A. An assistive personnel prevents a client from leaving the facility:

This situation may raise ethical concerns related to patient autonomy and freedom of movement. However, it is not a clear example of negligence. Negligence is more directly related to the provision of care and the failure to meet the standard of care.

B. An assistive personnel discusses client care in the facility cafeteria with visitors present:

This situation involves a breach of confidentiality and may violate the Health Insurance Portability and Accountability Act (HIPAA). However, it is not an example of negligence. Negligence typically involves a failure to provide appropriate care rather than a breach of privacy.

C. A nurse administers a medication without first identifying the client:

This is an example of negligence. Negligence refers to the failure to provide the standard of care that a reasonably prudent person would have provided under similar circumstances. In this case, administering medication without first identifying the client is a breach of the standard of care, and it can lead to serious consequences, including harm to the patient.

D. A nurse begins a blood transfusion without obtaining consent from a client:

This is an example of a legal issue related to lack of informed consent. While it raises ethical and legal concerns, it may not necessarily be considered negligence, which is more related to a failure in providing care up to the standard. However, it is still a serious violation of ethical and legal principles.