A nurse is preparing to initiate a blood transfusion for a client. Which action should the nurse take first to ensure client safety?
Verify the client's identity and blood type with two unique identifiers.
Confirm the expiration date of the blood product.
Assess the client's vital signs, including temperature, pulse, and blood pressure.
Obtain informed consent from the client for the blood transfusion.
The Correct Answer is A
A) Correct: The nurse should verify the client's identity and blood type with two unique identifiers, such as asking the client to state their full name and date of birth and comparing it to their identification band. This step ensures that the correct blood product is administered to the right client, promoting safety.
B) Incorrect: Confirming the expiration date of the blood product is important but not the first step in ensuring client safety during a blood transfusion. The nurse should first verify the client's identity and blood type.
C) Incorrect: Assessing the client's vital signs is essential, but it is not the first action to be taken. Verifying the client's identity and blood type is the priority before starting the transfusion.
D) Incorrect: Obtaining informed consent from the client is crucial but not the first action to be taken. The nurse should first verify the client's identity and blood type before seeking consent for the transfusion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) Incorrect: Administering a bolus of normal saline may help increase intravascular volume, but it is not the first intervention to be implemented. The nurse should first identify the cause of the client's symptoms and take appropriate actions.
B) Correct: The client's symptoms of feeling lightheaded and dizzy, along with a drop in blood pressure and an increase in heart rate, suggest orthostatic hypotension. The nurse's first intervention should be to elevate the client's feet and lower the head to improve blood flow to the brain.
C) Incorrect: Checking the client's hemoglobin and hematocrit levels is essential but may not be the first intervention in this situation. The client's symptoms indicate an immediate need to address the orthostatic hypotension.
D) Incorrect: Notifying the healthcare provider for further evaluation is important, but it may not be the first intervention. The nurse should first take immediate actions to address the client's symptoms of orthostatic hypotension.
Questions
Correct Answer is D
Explanation
A) Incorrect: Fresh Frozen Plasma (FFP) contains clotting factors and is not the primary treatment for hypoalbuminemia.
B) Incorrect: Platelets are used to treat thrombocytopenia and platelet dysfunction, not hypoalbuminemia.
C) Incorrect: Packed Red Blood Cells (PRBCs) are primarily used to improve oxygenation in anemic clients and do not address hypoalbuminemia.
D) Correct: Albumin is the blood product of choice for addressing severe hypoalbuminemia. It is a protein that helps maintain oncotic pressure and regulates fluid balance within the blood vessels.
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