Free NCLEX RN Practice Quiz | Blood Transfusion - نقل الدم | إختبار عملي للتمريض

The client in this situation is experiencing transfusion reaction so the priority action of the nurse is to first stop the transfusion.

The nurse must assess the vital signs before and 15 minutes after the procedure so that any changes during the transfusion may indicate a transfusion reaction is happening.

Usually, a transfusion reaction occurs within the 15 minutes of a transfusion.

0.9% sodium chloride is a standard solution used to follow infusion of blood products.

Options B, C, and D: IV solution containing dextrose in water will hemolyze red cells.

The safe storage of blood usually takes 35 days. Examining the expiration date is an important responsibility of a nurse prior hanging the blood.

The in-line filter helps ensure that any particles larger than the size of the filter are caught in the filter and are not infused with the client.

Option A is incorrect since the tubing that should be used is a macro drip.
Option B is used for administration of IV medication infusion.
Option C is incorrect since blood does not need any protection from light.

If the client has a temperature higher than 100 ° F, the unit of blood should be hung and delayed until the physician is notified and has the opportunity to give further order.

Options A and C are incorrect since the administration of the medicine will need the physician’s prescription.
Option B: The decision to administer the blood is not within the scope of nurse practice.

The nurse will infuse normal saline at a KVO rate to keep the patency of the IV line while waiting for further orders from the physician.

Option A: IV solution containing dextrose will hemolyze the red cells.
Option C: The nurse will not remove the IV line because then there would be no IV access route.
Option D: Doing a fast drip will potentially lead to congestion and is not done without the physician order.

This will help the nurse take immediate action incase a reaction happens during a transfusion.

Fresh-frozen plasma may be used to provide clotting factors or volume expansion. It is rich in clotting factors and can be thawed quickly and transfused right away.

Option B is incorrect since it will not specifically increase the hemoglobin, hematocrit, and neutrophil level.
Options C and D are incorrect since FFP does not contain any platelet.

Platelet transfusions may be given to prevent bleeding when the platelet count falls down.

Option A: A decline in the febrile episode will happen after the transfusion of agranulocytes.
Options B and D: An increased level of hemoglobin and hematocrit will happen after the transfusion of red blood cells.

Septicemia happens with the transfusion of blood that is contaminated with microorganisms. Assessment includes rapid onset of high fever and chills, hypotension, nausea, diarrhea, vomiting, and shock.

Option A: Circulatory overload causes hypertension, cough, dyspnea, chest pain, tachycardia, and wheezing upon auscultation.
Option B: Delayed reaction can occur days to years after a transfusion. It causes, fever, rashes, mild jaundice, and oliguria or anuria.
Option C: Hypocalcemia causes paresthesias, tetany, muscle cramps, hyperactive reflexes, positive Trousseau’s sign, and positive Chovstek’s sign.

The evaluation of an effective response of a cryoprecipitate transfusion is assessed by monitoring coagulation studies and fibrinogen levels.

Rapid transfusion of cool blood put the client at risk for cardiac dysrhythmias.

Options A and C are used to assess for any blood transfusion-related complication, but they do not prevent the occurrence of cardiac dysrhythmia.
Option D is not beneficial in this case since the infusion must be given rapidly.

A donation of the own blood is autologous. Doing this will prevent the risk of transfusion reaction.