IV Nutrition & Blood Products Flashcards

Which central vein placement is required for the administration of total parenteral nutrition (TPN) with dextrose concentrations greater than 10%?

Answer: Superior vena cava

TPN with dextrose >10% requires central venous placement (tip at the superior vena cava–right atrial junction) to allow high-flow dilution and prevent thrombophlebitis.

Before administering a unit of packed red blood cells (PRBCs), the nurse must verify the blood product with another licensed nurse. Which information must be matched?

Answer: Patient name, ID number, ABO/Rh type, unit number, expiration date, and any special processing requirements

Pre-transfusion verification requires two licensed nurses to confirm patient identity, ABO/Rh compatibility, unit number, expiration date, and special processing to prevent hemolytic reactions.

What is the maximum time a unit of packed red blood cells should hang and infuse once it leaves the blood bank?

Answer: 4 hours

PRBCs must be infused within 4 hours of leaving the blood bank refrigerator; beyond this, bacterial proliferation risk rises significantly.

Which IV solution is compatible for co-administration with packed red blood cells through a Y-type blood administration set?

Answer: Normal saline (0.9% NaCl)

Only normal saline (0.9% NaCl) is compatible with blood products; dextrose solutions cause RBC hemolysis and calcium-containing solutions (LR) promote clotting.

A patient receiving TPN develops hyperglycemia. Which nursing action is the first priority?

Answer: Notify the prescriber and monitor blood glucose per protocol; expect insulin order adjustment

TPN-induced hyperglycemia requires notifying the prescriber for insulin adjustment and frequent glucose monitoring; abrupt TPN discontinuation can cause rebound hypoglycemia.

Which filter is required when administering platelet transfusions?

Answer: Standard 170–260 micron blood filter

Platelets must be transfused through a standard 170–260 micron blood filter to remove clots and debris; 0.2-micron filters trap platelets and are contraindicated.