A nurse is teaching a client who is to begin chemotherapy about a peripherally inserted central catheter (PICC). Which of the following statements should the nurse include in the teaching?

A. Administer the unit of packed RBCs over 1 hr: Transfusing packed RBCs too quickly increases the risk of fluid overload and cardiovascular complications. Standard practice is to administer the unit over 2 to 4 hours, with careful monitoring for adverse reactions.

B. Obtain the client's first set of vital signs 1 hr after initiating the transfusion: Vital signs should be obtained immediately before starting the transfusion, then monitored closely during the first 15 minutes, when most acute transfusion reactions occur. Waiting an hour could delay recognition of complications.

C. Use Y tubing with 0.9% sodium chloride when administering the transfusion: Y tubing with normal saline is the correct method for administering packed RBCs. Saline maintains patency of the line and prevents incompatibility reactions, as other IV solutions can cause hemolysis or chemical reactions with the blood product.

D. Initiate venous access with a 21-gauge needle: A 21-gauge needle is too small for safe administration of packed RBCs, as it can cause hemolysis. A larger gauge needle, typically 18–20 gauge, is recommended to ensure smooth transfusion and minimize cell damage.

A. Notify the fire department that oxygen is in use in the home.: Informing the local fire department ensures they are aware of the increased fire risk and can respond appropriately in case of an emergency. Home oxygen increases combustion potential, and early notification enhances overall household safety planning.

B. Increase the oxygen flow rate by 1 L if the client experiences dyspnea.: Changing oxygen flow rates without a prescription is unsafe because it can lead to CO₂ retention in some clients or inadequate oxygenation in others. Any adjustment to oxygen therapy must be made only by the provider to avoid complications.

C. Store oxygen tanks on their side when not in use.: Oxygen tanks should always be stored upright and secured to prevent rolling or falling, which could cause tank rupture or high-pressure release.

D. Replace the cotton blankets with wool and synthetic blankets.: Wool and synthetic materials can generate static electricity, which poses an ignition risk around oxygen. Cotton blankets are the safer option because they reduce friction and minimize static buildup.