A nurse is preparing to administer a 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 healthcare provider's prescription and confirm the client has signed informed consent.
- 2Ensure the client has a patent large-bore intravenous (IV) catheter and obtain baseline vital signs.
- 3Obtain the packed red blood cells from the blood bank.
- 4Perform dual verification of the client's identity and blood product details at the bedside with another qualified nurse.
- 5Prime the blood administration set with 0.9% sodium chloride and begin the transfusion at a slow rate.
- 6Remain with the client for the first 15 minutes of the infusion to monitor for any transfusion reactions.
Answer
The correct sequence begins with verifying the prescription and consent, followed by patient preparation (IV access, vital signs), retrieving the blood, performing bedside verification, initiating the transfusion, and finally, remaining with the patient for the first 15 minutes.
Safe administration of blood products requires a strict, prioritized sequence to minimize risks such as ABO incompatibility and bacterial contamination. The process begins with foundational requirements (prescription and consent). Next, the nurse must ensure the client is physically ready (patent IV, baseline vitals) before the blood is exposed to room temperature. Once the patient is ready, the blood is retrieved. Bedside verification with two nurses immediately precedes the transfusion. The transfusion is then initiated using only 0.9% sodium chloride. Finally, because severe reactions typically occur early in the transfusion, the nurse must remain with the client for the first 15 minutes.
Step-by-Step Solution
Key Concept
Blood Product Administration Sequence and Safety