The nurse is preparing to transfuse a client with a unit of packed red blood cells (PRBC’s). Which intravenous solution is correct for use with the PRBC transfusion?
0.9% Sodium Chloride (NS)
0.45% Sodium Chloride
5% dextrose in water (D5W)
Lactated Ringers Solution
The Correct Answer is A
A. 0.9% Sodium Chloride (NS): Normal saline is the only intravenous solution that is compatible with packed red blood cells. It maintains the integrity of the red blood cells and prevents hemolysis or clot formation during the transfusion, ensuring safe administration.
B. 0.45% Sodium Chloride: Hypotonic solutions like 0.45% sodium chloride can cause red blood cells to swell and hemolyze. Using this solution with PRBCs can lead to transfusion reactions and ineffective oxygen delivery.
C. 5% dextrose in water (D5W): Dextrose solutions are not compatible with blood products because they promote red blood cell clumping and hemolysis. Administration of PRBCs with D5W can result in serious transfusion complications.
D. Lactated Ringers Solution: Lactated Ringers contains calcium, which can interact with anticoagulants in stored blood and lead to clot formation in the IV line. It is therefore unsafe for use with PRBC transfusions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Ask the client about preferred forms of address: The safest and most respectful approach is to ask the client how they prefer to be addressed. This acknowledges the possibility of a name discrepancy, respects the client’s identity, and avoids assumptions based on appearance or chart information.
B. Explain that the chart must contain an error: Assuming the chart is wrong may embarrass the client or create mistrust. The chart could be accurate but reflect a preferred name, legal name, or gender identity that differs from appearance.
C. Apologize and declare confusion about the client: Expressing personal confusion can make the client uncomfortable and does not resolve the situation professionally. It may undermine the client’s confidence in the nurse’s competence.
D. Ask Mrs. Smith where her husband is right now: Making assumptions about marital status or gender based on chart name is inappropriate and irrelevant to the client’s care. This approach risks offense and does not clarify identity or preferred address.
Correct Answer is A
Explanation
A. “This condition is caused by the coronary arteries spasming, not by cholesterol.”: Providing accurate, factual information about Prinzmetal angina addresses the client’s confusion and anxiety. Explaining that the condition is due to coronary artery spasm, rather than atherosclerotic plaque, helps correct misconceptions and empowers the client.
B. “Just because you’re young and eat right doesn’t mean you can’t have plaque buildup.”: Prinzmetal angina is not caused by plaque buildup. It may increase anxiety and confusion rather than providing helpful education.
C. “I understand it can be upsetting to have coronary artery disease at your age.”: While empathetic, this statement reinforces a misunderstanding. The client does not have typical coronary artery disease from plaque; education about the actual condition is appropriate.
D. “I am sure everything will be alright.”: Providing reassurance without education does not address the client’s concern or correct her misconceptions. It may minimize her feelings and fail to provide necessary understanding of the condition.
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