The nurse is preparing to administer a unit of packed red blood cells to a hospitalized child. What is an appropriate action that applies to administering blood?
a. Take the vital signs every 15 minutes while blood is infusing.
b. Use blood within 1 hour of its arrival from the blood bank.
c. Administer the blood with 5% glucose in a piggyback setup.
d. Administer the first 50 ml of blood slowly and stay with the child.
ANS: D
The nurse should administer the first 50 ml of blood or initial 20% of volume (whichever is smaller) slowly and stay with the child. Vitals signs should be taken 15 minutes after initiation and then every hour, not every 15 minutes. Blood should be used within 30 minutes, not 1 hour. Normal saline, not 5% glucose, should be the IV solution.
You might also like to view...
Which of the following statements best summarizes Wald and Brewster's approach to home nursing?
a. "All services all the time" b. "Helping people to help themselves" c. "One person, one family, at a time" d. "Your home or ours"
A reliable indicator of reperfusion after fibrinolytic therapy is
a. dysrhythmias. b. Q waves. c. elevated ST segments. d. a rapid decrease in serum CK levels.
For which asthma patient is a beta2-adrenergic agonist best delivered by nebulizer?
a. 3-year-old child who has a broken leg b. 16-year-old boy who has a broken nose c. 25-year-old woman who is 8 months pregnant d. 60-year-old man who has an enlarged prostate gland
Which of the following clients presenting to the emergency department would most likely be diagnosed with a pathologic fracture?
A. Daisy, a 76-year-old competitor in the senior Olympics long jump competition. B. Reese, a 65-year-old long-haul truck driver with metabolic syndrome. C. Julius, an 81-year-old man who fractured his arm as the result of a ground-level fall. D. Leta, a 57-year-old woman with hyperparathyroidism.