A nurse is preparing to give a client an infusion of packed red blood cells (PRBCS). The nurse is priming her administration IV tubing, the nurse primes one side of the Y tubing with the blood and the other should be which solution?

DSW

0.3% NS

Lactated Ringers

0.9% NS

Answer and Explanation

The Correct Answer is D

A) D5W: Dextrose 5% in water (D5W) is not used with blood transfusions because it can cause hemolysis of the red blood cells due to its hypotonic nature. It can also potentially cause clumping and clotting.

B) 0.3% NS: This is a hypotonic saline solution, which can lead to hemolysis of red blood cells when used as a diluent for blood products. It is not appropriate for use in blood transfusions.

C) Lactated Ringers: Although lactated Ringer's solution is often used for fluid resuscitation, it contains calcium, which can cause clotting in the blood product. Therefore, it is not suitable for use with blood transfusions.

D) 0.9% NS: Normal saline (0.9% sodium chloride) is isotonic and the only solution recommended for use with blood transfusions. It does not cause hemolysis of red blood cells, does not alter the composition of the blood product, and helps to maintain the patency of the IV line. It is the standard diluent used in blood transfusions to ensure the safe administration of blood products.

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Correct Answer is A

Explanation

A) Edema: Fluid volume overload often leads to edema due to the excess fluid leaking out of the blood vessels into the interstitial spaces. This swelling is commonly observed in areas such as the ankles, legs, and hands.

B) Oliguria: Oliguria, or reduced urine output, is more indicative of fluid volume deficit or kidney dysfunction rather than overload. In fluid volume overload, the kidneys typically produce more urine to try to balance the excess fluid.

C) Hypotension: Fluid volume overload usually causes an increase in blood pressure rather than hypotension. Hypotension is more commonly associated with fluid volume deficit or severe fluid loss.

D) Hyperthermia: Hyperthermia is not a direct result of fluid volume overload. It is more related to conditions involving fever or infection. Fluid overload primarily affects fluid distribution and does not directly cause an increase in body temperature

A. Covering the client with a blanket B. Assessing the client's skin for a rash C. Notifying the provider D. Stopping the transfusion

Correct Answer is D

Explanation

A) Covering the client with a blanket:

Covering the client with a blanket may help manage chills, but it does not address the underlying cause of the symptoms. Stopping the transfusion takes precedence in ensuring patient safety.

B) Assessing the client's skin for a rash:

Assessing for a rash can help determine if an allergic reaction is occurring, but the priority is to stop the transfusion to prevent further complications and address the immediate risk.

C) Notifying the provider:

Notifying the provider is important for reporting and further management, but the immediate action should be stopping the transfusion to prevent potential adverse effects.

D) Stopping the transfusion:

Stopping the transfusion is the priority action as it addresses the immediate risk of a transfusion reaction, such as an allergic reaction or transfusion-related infection. This action helps prevent further complications and ensures the client's safety.

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A nurse is preparing to give a client an infusion of packed red blood cells (PRBCS). The nurse is priming her administration IV tubing, the nurse primes one side of the Y tubing with the blood and the other should be which solution?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who is having fluid volume overload. Which finding should the nurse expect for this client?

Correct Answer is A

Explanation

A nurse is monitoring a client who reports having chills and back pain during a blood transfusion. What is the nurse's PRIORITY action to complete?

Correct Answer is D

Explanation

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