Indicate APPROPRIATE or INAPPROPRIATE ACTION on the

Indicate APPROPRIATE or INAPPROPRIATE ACTION on the part of the RN. If INAPPROPRIATE, correct the statement… Steve RN received a written order from Dr. William Bertrand for Type and Crossmatch for 2 units of Packed Red Blood Cells for his patient Mrs Belinda Carmichael. Steve RN has collected his patient’s blood for Type & Crossmatch after using two identifiers and proceeded to label his patient’s blood sample at the bedside with Patient Name, Patient MRN, Patient DOB, Blood Band Number, and the date, time and his initials. Steve RN has placed his blood tube in a biohazard bag and sent the specimen to the Blood Bank. Steve RN witnessed Dr Bertrand speaking to Mrs Carmichael and determined that the physician obtained a signed consent for the Blood Transfusion. Steve RN collected a set of Vital Signs as well as performed a Head to Toe Assessment on Mrs Carmichael in which he determined there was no concern for Fever, Hypertension or Risk of Fluid Overload. Steve RN assessed Mrs Carmichael’s IV and determined the Blue 22 g Catheter was satisfactory for the Blood Transfusion. Steve RN called the Blood Bank and stated he was ready for the first unit of blood at 1130 am when another of his patients was due to return from Endoscopy. Steve RN primed his IV Y Set Tubing with a 250 mL bag of 0.45% Saline. Steve RN could not locate his colleague RN so he asked Sue the Nurses’ Aide to double check the Blood Unit with him. Steve RN spiked the bag of Packed Red Blood Cells. Steve RN asked Mrs Carmichael if she had any questions about receiving a Blood Transfusion. Steve RN connected the Y Set Tubing to the Saline Lock and set the IV Pump to run at 2 mL/minute. Steve RN asked Sue the Nurses’ Aide to stay with the patient for the first 15 minutes and then collect a set of Vital Signs. Mrs Carmichael reported itching and Sue the Nurses’ Aide noticed facial flushing and reported to Steve the RN. Steve RN requested a liter of 0.9% Saline from the PIXIS and primed a new IV Primary Line. Steve RN stopped the Blood Transfusion and connected the 0.9% Saline on the new IV Primary Line. Steve RN delegated Vital Signs every 5 minutes to Sue the Nurses’ Aide. Steve RN called the Charge Nurse Regina RN for assistance. Charge Nurse Regina contacted Dr Bertrand and informed him of the possible Blood Transfusion Reaction. Dr Bertrand determined the allergic reaction to be mild and entered a STAT order for 50 mg Diphenhydramine IV Push to be given and to resume the Blood Transfusion. Steve RN gave the Diphenhydramine through the Blood Tubing and restarted the Blood Transfusion at 150 mL/hour to assure that the Blood Transfusion would be complete in 3 hours. Charge Nurse Regina contacted the Blood Bank and informed them of the mild allergic reaction. Steve RN determined the bag of Packed Red Blood Cells was empty at 1420 so he disconnected the Y Set Tubing and disposed of it in a Biohazard Bag. Steve RN delegated the 1530 H & H draw to Sue the Nurses’ Aide. SCIENCE HEALTH SCIENCE NURSING BSN NURSING 3001

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