Author Question: The primary intervention for a nurse who is preparing a blood transfusion is to: A. Set up the Y ... (Read 26 times)

audie · **on:** Jul 24, 2018

The primary intervention for a nurse who is preparing a blood transfusion is to:

A. Set up the Y tubing
B. Obtain 0.9 saline
C. Verify the blood product and the client
D. Have the client void, or empty the urine drainage container

Question 2

The nurse notes that urine does not flow after a female patient is catheterized. The nurse believes that the catheter has been placed into the vagina. Which action should the nurse take?

a. Remove the catheter and reinsert it.
b. Irrigate the catheter with saline.
c. Leave the catheter in place and insert another one.
d. Insert the catheter 9 to 10 inches farther into the patient to verify that it is in the vagina.

kaillie · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

C
C. Step 1b. Correctly verify product and identify client with a person considered qualified by your agency
A. Step 2c. Y tubing is used to facilitate maintenance of IV access in case a client will need more than 1 unit of blood.
B. Step 2e. Spike 0.9 normal saline IV bag with one of Y tubing spikes.
D. Step 1b(7)c. Empty urine drainage collection container, or have client void.

Answer to Question 2

C
If no urine appears, check whether the catheter is in the vagina. If misplaced, leave the catheter in the vagina as a landmark indicating where not to insert it, and insert another catheter into the meatus. Reinserting a catheter that has already been contaminated by vaginal exposure could lead to urinary tract infection.