The nurse is preparing to start a transfusion of packed red blood cells for a client with a hemoglobin of 5.4 g/dL. (normal Female: 11.7-15.5 g/dL; Male: 14-17.3 g/dL). Which IV site should the nurse use?

20-gauge catheter in the right wrist infusing IV antibiotics

18-gauge catheter infusing 20 mEq Potassium Chloride IV

22-gauge catheter in the left forearm infusing 0.9% Normal Saline

20-gauge catheter in the right forearm infusing 0.9% Normal Saline

Answer and Explanation

The Correct Answer is D

A.   The 20-gauge catheter in the right wrist is not ideal for blood transfusions, as wrist veins are smaller and may be less optimal for high-flow transfusions.
B.   An 18-gauge catheter is appropriate for blood transfusions, but the catheter is currently in use for potassium chloride, which would need to be discontinued. The best choice is a separate site.
C.   A 22-gauge catheter is not large enough for blood transfusion; it may cause hemolysis or slow the transfusion rate.
D.   The 20-gauge catheter in the right forearm is an appropriate size for a blood transfusion and is currently infusing normal saline, which does not interfere with the blood transfusion.

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Correct Answer is A

Explanation

A. INR = 3.7: The International Normalized Ratio (INR) is a measure of blood clotting. An INR greater than
3.0 indicates that the blood is not clotting properly, which can be caused by warfarin overdose. An elevated INR requires FFP to correct coagulopathy.
B. Hemoglobin = 6.3g/dL: This is low, indicating anemia, but it is not directly related to warfarin overdose. The primary issue here is coagulopathy, not anemia.
C. Fibrinogen = 90mg/dL: Fibrinogen levels may be decreased in various conditions, but this alone does not necessarily require additional FFP unless it’s below a critical threshold. Fibrinogen is not the main marker for warfarin overdose.
D. Platelets = 101,000 mm3: This platelet count is within the lower end of the normal range but does not indicate that more FFP is needed in response to warfarin overdose.

A. Perform a 12 lead EKG and request an order for bumetanide 0.5 mg IV B. Administer pantoprazole sodium 40 mg by mouth to decrease GI distress C. Administer carvedilol 10 mg by mouth and reassess in 30 minutes D. Complete the remainder of the assessment and continue to monitor

Correct Answer is D

Explanation

A. The 12-lead EKG might be unnecessary right now, especially since the client has no other alarming symptoms. Bumetanide is also not indicated for nausea or tachycardia in this scenario.
B. There is no clear indication that the nausea is related to acid reflux or GI distress that would justify pantoprazole.
C. The tachycardia could be physiological, and treating it with a beta-blocker is unnecessary unless there is a more concerning underlying cause (like heart failure or ischemia). The priority here is not pharmacological intervention but monitoring the client's overall condition.
D. This action allows for appropriate monitoring of the client's condition. Sinus tachycardia may resolve on its own without intervention, and the client doesn't exhibit severe symptoms requiring immediate pharmacologic treatment.

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The nurse is preparing to start a transfusion of packed red blood cells for a client with a hemoglobin of 5.4 g/dL. (normal Female: 11.7-15.5 g/dL; Male: 14-17.3 g/dL). Which IV site should the nurse use?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who received a transfusion of Fresh Frozen Plasma (FFP) for an acute GI bleed related to accidental wantarin overdose. Which laboratory result would indicate the need for an additional unit of Fresh Frozen Plasma (FFP) to correct the problem caused by the overdose?

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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