The patient is scheduled to receive 1 unit of packed RBCs. She ...

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The patient is scheduled to receive 1 unit of packed RBCs. She has small, fragile veins, and a 22-gauge intravenous (IV) patent catheter is in place. What should the nurse do?
 
  a. Cancel the blood transfusion.
  b. Insert a 16-gauge IV catheter into the antecubital fossa.
  c. Use the IV catheter that is in place.
  d. Transfuse the blood over 6 hours.

Question 2

The patient is scheduled to receive a blood transfusion. Preadministration laboratory tests are run to assess the level of which component in the patient's blood?
 
  a. Sodium (Na)
  b. Calcium (Ca)
  c. Potassium (K)
  d. Iron (Fe)

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Answer to Question 1

C
In emergency situations that require rapid transfusions, a large-gauge cannula is preferred; however, transfusions for therapeutic indications may be infused with cannulas ranging from 20 to 24 gauge. Large-gauge cannulas (18 or 20 gauge) promote rapid flow of blood components. 16-Gauge catheters are used frequently in surgery, but not usually on acute care units. Blood must be transfused within 4 hours. Use of smaller-gauge cannulas, such as 24 gauge, often requires the blood bank to divide the unit so that each half can be infused within the allotted time or requires the use of pressure-assisted devices.

Answer to Question 2

C
When blood is stored, there is continual destruction of RBCs, which releases potassium from the cells into the plasma. If blood is transfused rapidly, transient elevated potassium levels may occur before the potassium is reabsorbed and put the patient at risk.

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TYSM