Author Question: A client has severe anemia and will be receiving blood transfusions. The nurse prepares and be-gins ... (Read 123 times)

colton · **on:** Jul 23, 2018

A client has severe anemia and will be receiving blood transfusions. The nurse prepares and be-gins the infusion. Ten minutes after the infusion has begun, the client develops tachycardia, chills, and low back pain.

After stopping the transfusion, the nurse should:
1. Administer an antipyretic
2. Begin an infusion of epinephrine
3. Run normal saline through the blood tubing
4. Obtain and send a urine specimen to the laboratory

Question 2

The nurse recognizes that the client, based on the imbalance that is present, will require fluid re-placement with isotonic solution. One of the isotonic solutions that may be ordered by the health care provider is:

1. 0.45 saline
2. Lactated Ringer's
3. 5 dextrose in normal saline
4. 5 dextrose in lactated Ringer's

ryhom · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: 4
After stopping the blood transfusion, the nurse should obtain and send a urine specimen to the laboratory to determine the presence of hemoglobin as a result of red blood cell (RBC) hemoly-sis. In an acute hemolytic reaction, management of the reaction does not include the administra-tion of an antipyretic. The nurse should be prepared to administer emergency drugs, such as diu-retics, per the health care provider's order. The nurse should not turn off the blood and simply turn on the normal saline that is connected to the Y-tubing set. This would cause blood remaining in the Y-tubing to infuse into the client. Even a small amount of mismatched blood can cause a major reaction. The nurse should run normal saline directly into the IV line (not through the blood tubing).

Answer to Question 2

ANS: 2
Lactated Ringer's is an isotonic solution. 0.45 saline is a hypotonic solution. 5 dextrose in normal saline and 5 dextrose in lactated Ringer's are both hypertonic solutions.