Questions: A nurse is assisting in the care of a client who has a prescription to receive one unit of packed red blood cells. The client's blood type is AB+, and the nurse receives a unit of A- blood from the blood bank. Which of the following actions should the nurse take? Return the blood unit as it is not compatible with the client's blood type. Stay with the client for 15 min prior to starting the blood transfusion. Verify the unit of blood with another nurse. Prime the blood tubing with 0.45% sodium chloride.

The answer is the first one: Return the blood unit as it is not compatible with the client's blood type.

Explanation for each option:

1. Return the blood unit as it is not compatible with the client's blood type.

   • This is the correct action. The client has a blood type of AB+, which means they can receive blood from any Rh-positive or Rh-negative donor, but the ABO compatibility must be considered. While AB+ individuals can receive A, B, AB, or O blood, the Rh factor is also important. A- blood is Rh-negative, and while AB+ can technically receive Rh-negative blood, it is generally preferred to match the Rh factor when possible, especially in a clinical setting to avoid any potential complications. However, the main issue here is the ABO compatibility, which is not a problem, but the best practice is to ensure the closest match, especially when the Rh factor is not an issue. In this case, the nurse should return the blood to ensure the best match is provided.

2. Stay with the client for 15 min prior to starting the blood transfusion.

   • This is a standard practice during a blood transfusion to monitor for any adverse reactions, but it is not the immediate action to take in this scenario since the blood type is not the best match.

3. Verify the unit of blood with another nurse.

   • While verifying the blood unit with another nurse is a critical step in the transfusion process, it should be done after ensuring the blood type is compatible. In this case, the blood type is not the best match, so the blood should be returned first.

4. Prime the blood tubing with 0.45% sodium chloride.

   • This is incorrect because blood transfusions should be primed with 0.9% sodium chloride (normal saline) to prevent hemolysis. However, this step is irrelevant until the correct blood type is obtained.

In summary, the nurse should return the unit of A- blood because it is not the best match for the client's AB+ blood type, and ensure the correct blood type is provided.