A nurse is preparing to administer a unit of packed RBCs to a client. Which of the following actions should the nurse plan to take?

Rationale: A. Use Y tubing with 0.9% sodium chloride when administering the transfusion: Y-type blood tubing allows simultaneous infusion of packed red blood cells and 0.9% sodium chloride while maintaining a closed system. Normal saline is the only compatible IV solution for blood products, preventing hemolysis and maintaining the integrity of the red blood cells. B. Obtain the client's first set of vital signs 1 hr after initiating the transfusion: Vital signs should be obtained immediately before starting the transfusion, monitored closely within the first 15 minutes, and periodically throughout the infusion. Waiting an hour before assessment could delay detection of acute transfusion reactions, which often occur at the start of the transfusion. C. Administer the unit of packed RBCs over 1 hr: Rapid infusion of packed red blood cells over one hour is generally too fast for most adults and increases the risk of circulatory overload and adverse reactions. Standard practice is to transfuse one unit over 2–4 hours unless otherwise prescribed. D. Initiate venous access with a 21-gauge needle: Blood products should be administered through a larger-gauge IV (18–20 gauge) to reduce hemolysis of red blood cells and allow adequate flow. A 21-gauge needle may slow infusion and increase mechanical stress on the cells, potentially affecting the efficacy of the transfusion.