Indicate APPROPRIATE or INAPPROPRIATE ACTION on the

Indicate APPROPRIATE or INAPPROPRIATE ACTION on the part of the RN. If INAPPROPRIATE, correct the statement… Betsy RN received a written order from Dr. Nancy Sandoval for Type and Crossmatch for 2 units of Packed Red Blood Cells for her patient Mr Martin Sobeleski. Betsy RN has collected her patient’s blood for Type & Crossmatch after using two identifiers and proceeded to label her patient’s blood sample at the bedside with Patient Name, Patient MRN, Patient DOB, Blood Band Number, and the date, time and his initials. Betsy RN has placed his blood tube in a biohazard bag and sent the specimen to the Blood Bank. Betsy RN determined that Mr Sobeleski has received several units of Packed Red Blood Cells previously and was informed of the risks and benefits of the Blood Transfusion by Dr Sandoval. Betsy RN instructed Mr Sobeleski on the signs and symptoms of Blood Transfusion reaction and after determining that the patient was able to repeat the risks, benefits and signs & symptoms of reaction, Betsy RN witnessed a signed consent for the Blood Transfusion. Betsy RN collected a set of Vital Signs as well as performed a Head to Toe Assessment on Mr Sobeleski in which she determined there could be a risk for Fever, as he had previously had fevers with Blood Transfusions, Hypertension and Risk of Fluid Overload due to a mild Congestive Heart Failure diagnosis. Betsy RN contacted Dr Sandoval and discussed the previous history of fever and risk of fluid overload. She obtained an order to administer 650 mg Acetaminophen orally as well as 20 mg Furosemide via IV Push immediately prior to beginning the Blood Transfusion. Betsy RN started a new Saline Lock with a Pink 20 g IV Catheter. Betsy RN administered the Acetaminophen and Furosemide and placed a urinal at the bedside and instructed Mr Sobeleski to use the urinal and not get out of bed. Betsy RN raised the Head of the Bed. Betsy RN primed her IV Y Set Tubing with a 250 mL bag of 0.9% Saline. Betsy RN requested a liter of 0.9% Saline from the PIXIS and primed a new IV Primary Line. Betsy RN called the Blood Bank and stated she was ready for the first unit of blood at 1000 am after all morning medications and treatments were up to date. Betsy RN located her Charge Nurse Rhonda RN to double check the Blood Unit with her. Together they reviewed: the Patient’s Name, MRN, DOB, Blood Band and Blood Unit Numbers as well as Inspected the Blood Unit with its Expiration Date/Time. Additionally, they checked the written orders from Dr Sandoval, the signed consent, the previous vital signs, the orders for pre-medications and signs and symptoms of Blood Transfusion Reaction. Betsy RN asked Mr Sobeleski if he had any questions about receiving a Blood Transfusion after reviewing the Signs and Symptoms of Blood Transfusion Reaction. Betsy RN spiked the bag of Packed Red Blood Cells. Betsy RN connected the Y Set Tubing to the Saline Lock and set the IV Pump to run at 2 mL/minute. Betsy RN informed the Nurses’ Station Desk that she had initiated a Blood Transfusion and must stay at Mr Sobeleski’s bedside for the first 15 minutes and then collect a set of Vital Signs. Betsy RN was able to turn the rate to 120 mL/hour after the first 15 minutes because Mr Sobeleski had Vital Signs within normal parameters and no signs of dypnea, rales or jugular venous distension. Betsy RN noticed the bag of Packed Red Blood Cells was empty at 1300. She clamped the bag and opened the bag of 0.9% Saline to clear the IV Y Set of all the Blood. Betsy RN disconnected the IV Y Set Tubing at 1315 and disposed of the bags and tubing in a Biohazard bag. Betsy RN collected another set of Vital Signs at 1315. Betsy RN primed a new Y Set Tubing with a new 250 mL bag of 0.9% Saline. Betsy RN contacted to Blood Bank and asked for the second unit of Packed Red Blood Cells. SCIENCE HEALTH SCIENCE NURSING BSN NURSING 3001

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