A nurse is preparing to administer a blood transfusion to a patient.
What should the nurse consider when selecting an intravenous site for the transfusion?
"I'll choose a site with infiltration or phlebitis.”
"I'll use the same IV line for other medications.”
"I'll avoid using sites with edema or infection.”
"I'll use a 24-gauge IV catheter for the transfusion.”
The Correct Answer is C
Choice A rationale:
Choosing a site with infiltration or phlebitis is not appropriate for a blood transfusion.
Infiltration can lead to the transfused blood leaking into the surrounding tissues, and phlebitis can cause discomfort and complications.
A suitable site should be chosen for the transfusion.
Choice B rationale:
Using the same IV line for other medications without flushing it between medications can lead to drug interactions or contamination.
It is generally not recommended to mix blood transfusions with other medications in the same line.
Choice C rationale:
Avoiding sites with edema or infection is a crucial consideration when selecting an intravenous site for a blood transfusion.
Using a site with edema can make it difficult to insert the catheter, and using a site with infection can introduce pathogens into the bloodstream.
Choice D rationale:
Using a 24-gauge IV catheter for a blood transfusion may not be suitable for all patients.
The size of the catheter should be appropriate for the type of blood product being transfused and the patient's vein size.
A larger catheter may be necessary for blood products with higher viscosity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
"I'll verify the physician's order for the specific blood product."
Choice A rationale:
Selecting any available intravenous site for the transfusion without verifying the physician's order is unsafe and can lead to administering the wrong blood product or causing an adverse reaction in the patient.
Verifying the order is a critical step in ensuring patient safety during a blood transfusion.
Choice B rationale:
Using a blood administration set with additives may be necessary in some cases, but it is not the primary action the nurse should take before starting the transfusion.
Verifying the physician's order is the first and most crucial step.
Choice C rationale:
Verifying the physician's order for the specific blood product is essential to confirm that the correct blood type and unit are being administered to the patient.
This step ensures ABO and Rh compatibility and minimizes the risk of transfusion reactions.
Choice D rationale:
Administering the transfusion as quickly as possible is not appropriate and can be dangerous.
Transfusions should be administered at a controlled and appropriate rate to monitor for any adverse reactions.
Rushing the transfusion can increase the risk of complications.
Correct Answer is B
Explanation
Choice A rationale:
"I can receive blood from donors with blood types A-, O+, or O-." Rationale: This statement is incorrect because individuals with blood type A- can only receive blood from donors with blood type A- or O-.
Rh factor (positive or negative) is a critical consideration in blood compatibility.
Choice B rationale:
"I can receive blood from donors with blood types A- or O-." Rationale: This statement is accurate.
Individuals with blood type A- can safely receive blood from donors with blood type A- (the same type) or O- (universal donor for A- individuals)
The negative Rh factor ensures compatibility.
Choice C rationale:
"I can receive blood from donors with blood types A-, A+, O+, or O-." Rationale: This statement is incorrect.
Individuals with blood type A- should not receive blood from donors with A+ because the Rh factor is incompatible.
A- individuals can only safely receive Rh-negative blood.
Choice D rationale:
"I can receive blood from donors with blood types A-, A+, or O-." Rationale: This statement is incorrect because it suggests that an A- individual can receive blood from A+ donors.
As mentioned earlier, the Rh factor must be compatible, and A- individuals should not receive Rh-positive blood.
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