Pharmacological and Parenteral Therapies Q 96
A hospitalized patient is receiving packed red blood cells (PRBCs) for treatment of severe anemia. Which of the following is the most accurate statement?
A. Transfusion reaction is most likely immediately after the infusion is completed.
B. PRBCs are best infused slowly through a 20g. IV catheter.
C. PRBCs should be flushed with a 5% dextrose solution.
D. A nurse should remain in the room during the first 15 minutes of infusion.
Correct Answer: D. A nurse should remain in the room during the first 15 minutes of infusion.
Transfusion reaction is most likely during the first 15 minutes of infusion, and a nurse should be present during this period. The nurse remains with the client, observing signs and symptoms and monitoring vital signs as often as every 5 minutes. Meticulously verifying patient identification beginning with type and crossmatch sample collection and labeling to double-check blood product and patient identification prior to transfusion.
Option A: Transfusion reaction typically starts in the first 15 minutes of infusion. Beginning transfusion slowly ( 1 to 2 mL/min) and observing the patient closely, particularly during the first 15 minutes (severe reactions usually manifest within 15 minutes after the start of transfusion).
Option B: PRBCs should be infused through a 19g or larger IV catheter to avoid slow flow, which can cause clotting. Transfusing blood within 4 hours, and changing blood tubing every 4 hours to minimize the risk of bacterial growth at warm room temperatures.
Option C: PRBCs must be flushed with 0.45% normal saline solution. Other intravenous solutions will hemolyze the cells. Upon detection of any signs or symptoms of reaction, stop the transfusion immediately and notify the physician. Disconnect the transfusion set-but keep the IV line open with 0.9% saline to provide access for possible IV drug infusion.