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    ATI LPN Comprehensive Predictor 2023 Proctored Exam 3
    Select All That Apply

    The nurse is reviewing the client's medical record. Procedures Planned endoscopy at 1300. The nurse is assisting with the care of the client prior to a blood transfusion. Which of the following actions should the nurse take? Select all that apply.

    Explanation & Rationale

    A. Correct. The nurse should witness the client signing a consent form for blood transfusion. Informed consent is necessary for any medical procedure. B. Correct. A large bore IV catheter is required for blood transfusion to ensure the smooth flow of blood and prevent clotting. C. Correct. Two nurses should confirm the information on the blood label, including the client's identification and the blood type, to prevent errors. D. Incorrect. Transfusion tubing is typically flushed with normal saline before attaching it to the patient. Flushing with dextrose 5% in water is not necessary or recommended. E. Incorrect. It's important for the nurse to educate the client about potential transfusion reactions, as some reactions can indeed be serious. Providing accurate information helps the client understand the importance of monitoring for any signs of a reaction.

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