A nurse is assisting in the care of a client who is to receive a transfusion of packed RBCs. Which of the following solutions should the nurse obtain?

A. Dextrose 5% in water: D5W contains glucose, which can cause red blood cells to swell and hemolyze during transfusion. Hemolysis increases the risk of acute transfusion reactions and reduces the effectiveness of the transfused cells. This solution is therefore unsafe to use as a carrier fluid for blood products. B. Dextrose 5% in 0.45% sodium chloride: The presence of dextrose again creates a risk of hemolysis because glucose alters the osmotic stability of transfused RBCs. The hypotonic component further increases the likelihood of cell rupture during administration. This makes the solution incompatible with packed RBC transfusion. C. Lactated Ringer's: LR contains calcium, which can bind with the anticoagulant citrate in stored blood products. This can cause clot formation within the infusion line or blood bag, creating a serious safety risk. For this reason, LR should not be used when administering packed RBCs. D. 0.9% sodium chloride: Normal saline is isotonic and does not interact with the anticoagulants in stored blood, making it the safest and recommended solution for RBC transfusions. It maintains cell integrity and prevents clotting, ensuring the transfusion can be delivered effectively and without complications.