1. A nursing priority when administering a blood transfusion is to:
. Check the fibrinogen level before infusing.
. Infuse blood slowly the first 20 minutes.
. Warm the blood prior to administration.
. Infuse the blood over 1 to 2 hours.
Test-Taking Tip
This is a priority question; therefore, other options could be correct. Look for the action that protects the client from injury—think safety.
Content Area: Adult Health, Hematological; Integrated Process: Nursing Process, Analysis; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Pharmacological and Parenteral Therapies/Blood and Blood Products
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Answer 1 is incorrect because there is no risk to the client from fibrinogen, which is a protein that is converted into fibrin to form a thrombus or clot. Answer 2 is correct because a hemolytic reaction will most likely occur during the first 20 minutes. Answer 3 is incorrect because warming is not required, but may be more comfortable for the client. Answer 4 is incorrect because the rate of infusion could be up to 4 hours.