Initiating a Transfusion Skills

The nurse is preparing equipment to administer a unit of blood to a patient. Which type of fluid would the nurse piggyback with the blood transfusion? A. 0.45% normal saline B. 0.9% normal saline C. Dextrose 5% and 0.45% normal saline D. Dextrose 5% and 0.9% normal saline

B. 0.9% normal saline Rationale: Blood and blood products can be administered only with 0.9% normal saline. No other solution is to be administered or piggybacked with blood or blood products. Only 0.9% normal saline solution, not 0.45% normal saline, can be used to administer blood. No other solution is to be administered or piggybacked with blood or blood products. Solutions that contain dextrose cause blood to coagulate and must not be administered or piggybacked with blood or blood products.

A patient is to receive one unit of packed red blood cells over 2 hours. Which rate is the usual flow rate for the first 15 minutes of a blood transfusion? A. 1 mL/min B. 2 mL/min C. 10 mL/min D. 25 mL/min

B. 2 mL/min Rationale: The nurse would infuse only 2 mL/min during the first 15 minutes of the blood transfusion. Transfusing the packed red blood cells at the rate of 1 mL/min is too slow. Transfusing the packed red blood cells at the rate of 10 mL/min is too fast. Only 2 mL/min is to infuse during the first 15 minutes of the blood transfusion. It would be appropriate to increase the rate to 25 mL/min after the first 15 minutes of the transfusion.

A patient received two 300-mL units of packed red blood cells, and the line was flushed with 25 mL of solution between the units. What is the total amount of fluid the nurse will document having provided to the patient? A. 675 mL B. 650 mL C. 625 mL D. 600 mL

C. 625 mL Rationale: Two units of 300 mL each totals 600 mL of blood. In addition, 25 mL of 0.9% normal saline solution was used to flush the line between the units. Adding the blood and the saline together yields 625 mL of fluid. The nurse will document that amount.

A patient is to receive 3 units of packed red blood cells over 8 hours. What will the nurse do to maintain the patency of the patient's IV access line after each of the first two units of blood has transfused? A. Infuse 0.9% normal saline at 100 mL/hour. B. Infuse dextrose 5% and 0.9% normal saline at the KVO (keep-vein-open) rate. C. Infuse 0.9% normal saline at the KVO rate. D. Cap the intravenous line.

C. Infuse 0.9% normal saline at the KVO rate. Rationale: When consecutive units are to be given, the patency of the IV line is maintained with 0.9% normal saline infusing at the KVO rate. Normal saline 0.9% is the correct solution, but an infusion rate of 100 mL/hr is too fast. Any solution containing dextrose is incompatible with blood and must not be infused into the same line used for blood or blood products. Capping the intravenous line will not maintain its patency between units of blood.

A patient prescribed to receive two units of packed red blood cells is to receive a dose of intravenous medication between the two units. How would the nurse administer the medication? A. In the IV line for the blood product during the transfusion B. In the IV line for the blood product when the line is flushed with normal saline C. In oral form D. Through another IV line

D. Through another IV line Rationale: The nurse would maintain a separate access line if IV solutions or medications are to be administered. Medication is never injected into the same IV line used for a blood component. The blood product may be incompatible with the medication, and the blood component could become contaminated if the same IV line is used for another purpose. Medication is never injected into the same IV line used for a blood component. The blood product may be incompatible with the medication, and the blood component could become contaminated if the same IV line is used for another purpose. Medication is never injected into the same IV line used for a blood component. The blood product may be incompatible with the medication, and the blood component could become contaminated if the same IV line is used for another purpose. The prescribed medication is to be given intravenously. The nurse cannot change the form of the medication that has been ordered.