Critical Care - Blood Administration

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Author:
nursedaisy98
ID:
256706
Filename:
Critical Care - Blood Administration
Updated:
2014-04-20 10:34:19
Tags:
NCLEX RN
Folders:
Critical Care
Description:
Blood Administration
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  1. Packed red blood cells have been prescribed for a client with low hemoglobin and hematocrit levels. The nurse takes the client's temperature before hanging the blood transfusion and records 100.6° F orally. Which action should the nurse take?
    1. Begin the transfusion as prescribed.
    2. Administer an antihistamine and begin the transfusion.
    3. Delay hanging the blood and notify the health care provider (HCP).
    4. Administer two tablets of acetaminophen (Tylenol) and begin the transfusion.
    3. Delay hanging the blood and notify the health care provider (HCP).
  2. The nurse has received a prescription to transfuse a client with a unit of packed red blood cells. Before explaining the procedure to the client, the nurse should ask which initial question?
    1. "Have you ever had a transfusion before?"
    2. "Why do you think that you need the transfusion?"
    3. "Have you ever gone into shock for any reason in the past?"
    4. "Do you know the complications and risks of a transfusion?"
    1. "Have you ever had a transfusion before?"
  3. A client receiving a transfusion of packed red blood cells (PRBCs) begins to vomit. The client's blood pressure is 90/50 mm Hg from a baseline of 125/78 mm Hg. The client's temperature is 100.8° F orally from a baseline of 99.2° F orally. The nurse determines that the client may be experiencing which complication of a blood transfusion?
    1. Septicemia
    2. Hyperkalemia
    3. Circulatory overload
    4. Delayed transfusion reaction
    1. Septicemia
  4. The nurse has just received a unit of packed red blood cells from the blood bank for transfusion to an assigned client. The nurse is careful to select tubing especially made for blood products, knowing that this tubing is manufactured with which item?
    1. An air vent
    2. Tinted tubing
    3. An in-line filter
    4. A microdrip chamber
    3. An in-line filter
  5. A client has received a transfusion of platelets. The nurse evaluates that the client is benefiting most from this therapy if the client exhibits which finding?
    1. Increased hematocrit level
    2. Increased hemoglobin level
    3. Decline of elevated temperature to normal
    4. Decreased oozing of blood from puncture sites and gums
    4. Decreased oozing of blood from puncture sites and gums
  6. The nurse has obtained a unit of blood from the blood bank and has checked the blood bag properly with another nurse. Just before beginning the transfusion, the nurse should assess which priority item?
    1. Vital signs
    2. Skin color
    3. Urine output
    4. Latest hematocrit level
    1. Vital signs
  7. The nurse has just received a prescription to transfuse a unit of packed red blood cells for an assigned client. Approximately how long will the nurse need to stay with the client to ensure that a transfusion reaction is not occurring?
    1. 5 minutes
    2. 15 minutes
    3. 30 minutes
    4. 45 minutes
    2. 15 minutes
  8. The nurse, listening to the morning report, learns that an assigned client received a unit of granulocytes the previous evening. The nurse makes a note to assess the results of which daily serum laboratory studies to assess the effectiveness of the transfusion?
    1. Hematocrit level
    2. Erythrocyte count
    3. Hemoglobin level
    4. White blood cell count
    4. White blood cell count
  9. A client is brought to the emergency department having experienced blood loss related to an arterial laceration. Fresh-frozen plasma is prescribed and transfused to replace fluid and blood loss. The nurse understands that which is the rationale for transfusing fresh-frozen plasma to this client?
    1. To treat the loss of platelets
    2. To promote rapid volume expansion
    3. Because a transfusion must be done slowly
    4. Because it will increase the hemoglobin and hematocrit levels
    2. To promote rapid volume expansion
  10. The nurse who is about to begin a blood transfusion knows that blood cells start to deteriorate after a certain period of time. Which item is important to check regarding the age of blood cells before the transfusion is begun?
    1. Expiration date
    2. Presence of clots
    3. Blood group and type
    4. Blood identification number
    1. Expiration date
  11. A client requiring surgery is anxious about the possible need for a blood transfusion during or after the procedure. The nurse suggests to the client to take which actions to reduce the risk of possible transfusion complications? Select all that apply.
    1. Ask a family member to donate blood ahead of time.
    2. Give an autologous blood donation before the surgery.
    3. Take iron supplements before surgery to boost hemoglobin levels.
    4. Request that any donated blood be screened twice by the blood bank.
    5. Take adequate amounts of vitamin C several days prior to the surgery date.
    • 1. Ask a family member to donate blood ahead of time.
    • 2. Give an autologous blood donation before the surgery.
  12. A client with severe blood loss resulting from multiple trauma requires rapid transfusion of several units of blood. The nurse asks another health team member to obtain which device for use during the transfusion procedure to help reduce the risk of cardiac dysrhythmias?
    1. Infusion pump
    2. Pulse oximeter
    3. Cardiac monitor
    4. Blood-warming device
    4. Blood-warming device
  13. A client has a prescription to receive a unit of packed red blood cells. The nurse should obtain which intravenous (IV) solution from the IV storage area to hang with the blood product at the client's bedside?
    1. Lactated Ringer's
    2. 0.9% sodium chloride
    3. 5% dextrose in 0.9% sodium chloride
    4. 5% dextrose in 0.45% sodium chloride
    2. 0.9% sodium chloride
  14. One unit of packed red blood cells has been prescribed for a client with severe anemia. The client has received multiple transfusions in the past, and it is documented that the client has experienced urticaria-type reactions from the transfusions. The nurse anticipates that which medication will be prescribed before administration of the red blood cells to prevent this type of reaction?
    1. Ibuprofen (Motrin IB)
    2. Acetaminophen (Tylenol)
    3. Acetylsalicylic acid (aspirin)
    4. Diphenhydramine (Benadryl)
    4. Diphenhydramine (Benadryl)
  15. A nurse has a prescription to transfuse a unit of packed red blood cells to a client who does not currently have an intravenous (IV) line inserted. When obtaining supplies to start the IV infusion, the nurse should select an angiocatheter of which size?
    1. 20 gauge
    2. 21 gauge
    3. 22 gauge
    4. 24 gauge
    1. 20 gauge
  16. A client has experienced a rash with pruritus during previous blood transfusions. The client asks the nurse whether it is safe to receive another transfusion. In formulating a response, the nurse incorporates the understanding that which medication most likely will be prescribed before the transfusion is begun?
    1. Ibuprofen (Motrin IB)
    2. Acetaminophen (Tylenol)
    3. Diphenhydramine (Benadryl)
    4. Acetylsalicylic acid (ASA) (aspirin)
    3. Diphenhydramine (Benadryl)
  17. The nurse is told by a health care provider that a client in hypovolemic shock will require plasma expansion. The nurse anticipates receiving a prescription to transfuse which product?
    1. Albumin
    2. Platelets
    3. Cryoprecipitate
    4. Packed red blood cells
    1. Albumin
  18. The nurse has discontinued a unit of blood that was infusing into a client because the client experienced a transfusion reaction. After documenting the incident appropriately, the nurse sends the blood bag and tubing to which department?
    1. Blood bank
    2. Infection control
    3. Risk management
    4. Environmental services
    1. Blood bank
  19. The nurse has just obtained a unit of blood from the blood bank to transfuse into a client as prescribed. Before preparing the blood for transfusion, the nurse looks for which member of the health care team to assist in checking the unit of blood?
    1. Phlebotomist
    2. Medical student
    3. Registered nurse (RN)
    4. Blood bank technician
    3. Registered nurse (RN)
  20. The nurse is picking up a unit of packed red blood cells at the hospital blood bank. After putting the pen down, the nurse glances at the clock, which reads 1:00. The nurse calculates that the transfusion must be started by which time?
    1. 1:30
    2. 2:00
    3. 2:30
    4. 3:00
    1. 1:30
  21. The nurse enters a client's room to assess the client, who began receiving a blood transfusion 45 minutes earlier, and notes that the client is flushed and dyspneic. On assessment, the nurse auscultates the presence of crackles in the lung bases. The nurse determines that this client most likely is experiencing which complication of blood transfusion therapy?
    1. Bacteremia
    2. Hypovolemia
    3. Circulatory overload
    4. Transfusion reaction
    3. Circulatory overload
  22. A nurse is monitoring a client who is receiving a blood transfusion. After 30 minutes of the infusion, the client begins to have chills and back pain. His temperature is 100.1° F (37.8° C). What action should the nurse take first?
    1. Assess the client for other symptoms.
    2. Slow the blood transfusion and monitor the client's vital signs.
    3. Remind the client that these are expected reactions to a blood transfusion.
    4. Discontinue the infusion and start an infusion of normal saline using new tubing.
    4. Discontinue the infusion and start an infusion of normal saline using new tubing.
  23. The nurse enters a client's room who began receiving a blood transfusion 45 minutes earlier to check on the client. The client is dyspneic and has a bounding pulse. The nurse listens to the client's lung sounds and notes the presence of crackles in the lung bases. Which complication of blood transfusion therapy should the nurse determine that this client is most likely experiencing?
    1. Bacteremia
    2. Fluid overload
    3. Hypovolemic shock
    4. Allergic transfusion reaction
    2. Fluid overload
  24. A unit of packed red blood cells (PRBCs) was just received from the blood bank for transfusion to an assigned client. The nurse is careful to select tubing especially made for blood products, knowing that this tubing is manufactured with which feature?
    1. An air vent
    2. An in-line filter
    3. A microdrip chamber
    4. Tinted tubing to protect the blood from light
    2. An in-line filter
  25. A nurse overhears a health care provider (HCP) stating that a client who is in hypovolemic shock requires plasma expansion. Which blood product should the nurse anticipate that the HCP will write a prescription for?
    1. Albumin
    2. Platelets
    3. Cryoprecipitate
    4. Packed red blood cells
    1. Albumin
  26. A nurse is assisting in monitoring a client who is receiving a transfusion of packed red blood cells (PRBCs). Before leaving the room, the nurse tells the client that it is most important to immediately report which symptoms of a transfusion reaction? Select all that apply.
    1. Chills
    2. Fatigue
    3. Sleepiness
    4. Chest pain
    5. Low back pain
    6. Difficulty breathing
    • 1. Chills
    • 4. Chest pain
    • 5. Low back pain
    • 6. Difficulty breathing

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