Question

A nurse has two middle-aged clients who have a prescription to receive a

blood transfusion of packed red blood cells at the same time. The first client's blood
pressure dropped from the preoperative value of 120/80 mm Hg to a postoperative
value of 100/50. The second client is hospitalized because he developed dehydration
and anemia following pneumonia. After checking the patency of their IV lines and vital
signs, what should the nurse do next?
1. Call for both clients' blood transfusions at the same time.
2. Ask another nurse to verify the compatibility of both units at the same time.
3. Call for and hang the first client's blood transfusion.
4. Ask another nurse to call for and hang the blood for the second client.

Answer 1

The nurse should ask another nurse to verify the compatibility of both units of blood (option 2) before administering the blood transfusions to ensure that each client receives a compatible and safe transfusion, avoiding the risk of a potentially lethal hemolytic transfusion reaction.

Step-by-step explanation:

When handling multiple clients needing blood transfusions, the nurse's priority is to ensure patient safety by checking that each client receives blood that is compatible with their own. Performing a crossmatch test to verify blood compatibility is vital to prevent a hemolytic transfusion reaction which could be lethal. Each client’s blood type must be confirmed, and the compatibility of the donor blood must be established before transfusion.

In this scenario, the nurse should ensure that the blood transfusions are both compatible and safe for each individual client. Option 2 appears to be the most appropriate course of action. The nurse should ask another nurse to verify the compatibility of both units of blood to prevent any risk of administering a transfusion with incompatible ABO or Rh blood types. By doing this, the nurse is taking steps to avoid hemolytic transfusion reactions and ensuring that the transfusions will not result in complications such as fever, chills, itching, hives, dyspnea, hemoglobinuria, hypotension, or shock.