A nurse is preparing to administer a prescribed unit of packed red blood cells (PRBCs) to a client with severe anemia. In what order should the nurse perform the following actions? Arrange the steps in the correct chronological sequence.
- 1Verify the provider's prescription, confirm informed consent is signed, and assess baseline vital signs.
- 2Retrieve the unit of packed red blood cells from the blood bank.
- 3Verify the blood product, blood type, and client identity with a second registered nurse at the bedside.
- 4Spike the blood bag and initiate the transfusion at a slow rate of 2 mL/min.
- 5Remain with the client and reassess vital signs 15 minutes after the transfusion begins.
Answer
The correct chronological sequence is: Verify prescription/consent/vitals, Retrieve blood from the blood bank, Verify with a second nurse at the bedside, Initiate the transfusion slowly, and Remain with the client for 15 minutes to reassess vital signs.
Safe administration of packed red blood cells requires strict adherence to chronological safety checkpoints. First, the nurse must ensure the client is ready (consent, baseline vitals, patent IV) before retrieving the blood, as it expires in 30 minutes at room temperature. Once retrieved, two-nurse verification must occur at the bedside to prevent ABO incompatibility. The transfusion is initiated slowly to mitigate the severity of any potential reaction, and the nurse must remain with the client for the first 15 minutes, as this is when life-threatening reactions are most likely to occur.
Step-by-Step Solution
Key Concept
Blood Transfusion Administration Safety and Sequencing