Question

A nurse preceptor is observing a newly licensed nurse on the unit who is preparing to administer a blood transfusion to an older adult client. Which of the following actions by the newly licensed nurse indicates an understanding of the procedure?

A. Inserts an 18G IV catheter into the client.
B. Verifies blood compatibility and expiration date of the blood with an AP.
C. Administers D5W in 0.9% NaCL IV with the transfusion
D. Obtains VS every 15 min throughout the procedure.

Answer 1

A newly licensed nurse demonstrates understanding of blood transfusion procedures by obtaining vital signs every 15 minutes to monitor patient response and by being directly supervised by a registered nurse, underscoring their adherence to patient safety protocols.

Step-by-step explanation:

An action by a newly licensed nurse that indicates understanding of administering a blood transfusion procedure is obtaining vital signs (VS) every 15 minutes throughout the procedure. This practice is essential for monitoring the patient's response to the transfusion and quickly identifying any adverse reactions, such as an allergic reaction or a transfusion reaction. In addition to frequent vital signs monitoring, the newly licensed nurse should also be directly supervised by a registered nurse during the procedure, especially given the nurse's recent entry into professional practice.

Supervision ensures adherence to protocol and patient safety. Moreover, the nurse should review the patient's history, assess their current condition, and confirm the correct labeling of the blood product, ensuring that it matches the patient's blood type and is safe for transfusion. This meticulous approach is a part of hemovigilance systems, which track transfusion information to prevent transfusion-related adverse events.