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Multiple Choice
When a client is to receive a unit of packed red blood cells, what is the nurse's first action?
A
Administer the blood transfusion immediately.
B
Monitor the client's vital signs continuously.
C
Verify the client's blood type and crossmatch results.
D
Ensure the client has an intravenous line in place.
Verified step by step guidance
1
Understand the importance of blood transfusion safety: Before administering a blood transfusion, it is crucial to ensure compatibility between the donor's and recipient's blood types to prevent adverse reactions.
Identify the key steps in the blood transfusion process: These include verifying the client's blood type, crossmatching results, ensuring an intravenous line is in place, and monitoring vital signs.
Prioritize the actions based on safety protocols: The first action should be to verify the client's blood type and crossmatch results to ensure compatibility and prevent transfusion reactions.
Explain the rationale: Verifying blood type and crossmatch results is essential to confirm that the blood product is safe for the client, reducing the risk of hemolytic reactions.
Prepare for subsequent steps: Once compatibility is confirmed, ensure the client has an intravenous line in place and monitor vital signs during the transfusion to detect any immediate adverse reactions.