On a nursing unit all assigned breaks including lunch/dinner breaks are assigned at the beginning of the shift

Question

A nurse caring for a patient with anemia and heart failure prepares to hang a unit of packed red blood cells and realizes her break is in 5 minutes. She decides it is not necessary to have another nurse check the blood against the patient's information since the patient's blood type is O+ which she incorrectly remembered to be the universal donor. She hangs the blood, noting the patient is "reading and vital signs normal." She leaves the floor for her break and does not report leaving or ask anyone to perform required vital signs. Upon returning she meets a family friend who is visiting and time "just flies." She returns to the patient's room after admitting a new patient. The patient is hypotensive and color is cyanotic and anxious. She reports the findings to the charge nurse, who then contacts the physician. A blood reaction occurrence is noted. The nurse providing care is charged:
a. with comparative negligence.
b. with a preventable adverse event.
c. with criminal negligence.
d. under the doctrine of res ipsa loquitur.

Answer 1

ANS: C
Correct: In this case, criminal negligence charges would be based on "reckless and wanton" disregard for the safety, well-being, or life of an individual; behavior that demonstrates a complete disregard for another, such that death is likely in the transfusion reaction. Type "O" is the universal donor rather than universal recipient; however, regardless of blood type, policy and procedures for assessing vital signs and patient status during blood transfusion must be followed.
Incorrect:
a. This does not represent comparative negligence since the charge nurse did not contribute to the patient's injury.
b. A preventable adverse effect is not applicable since the injury was caused by medical management rather than the patient's underlying condition.
d. The doctrine of res ipsa loquitur ("the thing speaks for itself") does not apply since lay persons would not possess the scientific and technologic knowledge necessary to determine the required standard of care.