A client diagnosed with symptomatic anemia is currently receiving a transfusion of packed red blood cells via a 20-gauge peripheral intravenous catheter. Following a sudden drop in blood pressure to 85/50 mmHg, the healthcare provider prescribes a rapid bolus of Lactated Ringer's solution. Which action is most appropriate for the nurse to take?
- AConnect the ordered fluid to the Y-port on the existing blood administration tubing.
- BDelay the administration of the fluid bolus until the blood product has completely infused.
- Establish a second peripheral intravenous access site to infuse the ordered crystalloid solution.Answer
- DTemporarily halt the transfusion, run the fluid bolus through the current line, and then restart the blood.
Answer
The nurse must establish a second peripheral intravenous access site to administer the Lactated Ringer's solution.
Packed red blood cells are compatible only with 0.9% sodium chloride. Lactated Ringer's contains calcium, which can bind to the citrate anticoagulant in the blood product and cause the blood to clot in the tubing. Because the client is experiencing acute hypotension that requires immediate fluid resuscitation, the most appropriate action is to establish a new intravenous access site to administer the Lactated Ringer's concurrently without compromising the blood transfusion or patient safety.
Step-by-Step Solution
Key Concept
Blood Product Compatibility and Intravenous Therapy