Question

A nurse is caring for a client who is receiving a blood transfusion. The client becomes restless, dyspneic, and has crackles noted to the lung bases. Which of the following actions should the nurse anticipate taking?

a) Administering more blood rapidly.
b) Slowing down the transfusion rate.
c) Assessing vital signs and oxygen saturation.
d) Documenting the client's reaction.

Answer 1

The nurse should anticipate assessing vital signs and oxygen saturation.

Step-by-step explanation:

Based on the symptoms described, the nurse should anticipate taking the following action:

1. Assessing vital signs and oxygen saturation: Restlessness, dyspnea, and crackles in the lung bases are signs of respiratory distress. The nurse should check the client's vital signs, including heart rate, respiratory rate, blood pressure, and oxygen saturation, to monitor the severity of the client's condition.

Assessing the client's vital signs and oxygen saturation will provide crucial information about the client's respiratory status and guide further interventions.