During an ongoing transfusion of packed red blood cells (PRBCs) for a client with severe anemia, the client suddenly develops bilateral lung crackles, severe shortness of breath, and jugular venous distention. A rapid response is called, and the attending physician orders a stat dose of intravenous furosemide. The client currently has only one single-lumen peripheral intravenous catheter in place. What is the priority nursing action to safely administer this prescribed therapy?
- Establish a second peripheral vascular access site to administer the diuretic.Cevap
- BPause the blood product infusion, clear the tubing with sodium chloride, administer the medication, and then resume the blood.
- CConnect the medication syringe to the lowest injection port on the blood tubing and inject it over two minutes.
- DHold the medication until the blood transfusion is fully completed to prevent red blood cell hemolysis.
Cevap
The nurse must establish a new, secondary peripheral intravenous access site to safely administer the diuretic.
Blood products are highly sensitive and incompatible with almost all intravenous medications. Mixing furosemide with packed red blood cells can cause immediate hemolysis (destruction of red blood cells). Because the client is experiencing an acute, life-threatening complication (pulmonary edema secondary to fluid overload), the medication must be given immediately. The only safe and effective way to adhere to both the urgency of the situation and strict compatibility protocols is to establish a new vascular access site.
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Anahtar Kavram
Blood product compatibility and emergency medication administration principles.