A client with symptomatic anemia requires a transfusion of packed red blood cells (PRBCs). The client's only intravenous (IV) access is a 20-gauge peripheral catheter currently infusing 5% dextrose in water (D5W) at 75 mL/hr. What is the most appropriate action by the nurse?
- ADelegate the assessment of the client's vital signs and monitoring for adverse reactions during the first 15 minutes to an unlicensed assistive personnel (UAP).
- BConnect the PRBC transfusion tubing to the lowest Y-site port of the primary D5W infusion line to run them concurrently.
- Stop the continuous D5W infusion, flush the IV catheter with 0.9% sodium chloride, and administer the PRBCs with 0.9% sodium chloride.Cevap
- DCalculate the required drip rate to ensure the entire unit of PRBCs infuses slowly over a 6-hour period to prevent fluid overload.
Cevap
The most appropriate action is to stop the continuous D5W infusion, flush the IV catheter with 0.9% sodium chloride, and administer the PRBCs with 0.9% sodium chloride.
Packed red blood cells (PRBCs) are exclusively compatible with 0.9% sodium chloride (normal saline). Administering blood with solutions containing dextrose, such as D5W, causes hemolysis (rupture) of the red blood cells, which can trigger a severe or life-threatening reaction. Because the client has only one IV access site, the nurse must stop the incompatible D5W infusion, completely flush the line with 0.9% sodium chloride to clear any remaining dextrose from the catheter, and then administer the transfusion safely using normal saline as the primer and flush.
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Anahtar Kavram
Blood Product Administration Safety and IV Fluid Compatibility