What should a nurse plan when administering a unit of packed red blood cells?

When administering a unit of packed red blood cells, it is crucial for the nurse to remain with the client for the first 15 minutes of the transfusion. This initial period is critical because it is when the majority of transfusion reactions occur, particularly for acute reactions such as febrile non-hemolytic transfusion reactions or hemolytic reactions. By closely monitoring the patient during this time, the nurse can quickly identify any signs of a reaction such as fever, chills, or changes in vital signs, allowing for prompt intervention if necessary. This practice is a fundamental safety procedure that enhances patient care during blood transfusions.

Other options may not align with best practices. While monitoring over the entire transfusion is essential, infusing the unit of blood over six hours is too long and beyond recommended guidelines, as packed red blood cells typically should be transfused within 4 hours to minimize the risk of bacterial growth. Checking the unit of blood with unlicensed personnel undermines the necessary verification process, which should involve appropriately trained staff to ensure patient safety. Pre-medicating the client with an antiemetic is not a universally required step prior to blood transfusion, as it is typically reserved for patients with a history of reactions, rather than