medium · NCLEX-RN pharmacology
While monitoring a client receiving a unit of packed red blood cells, the nurse notes the client reports sudden low back pain and develops a temperature of 38.9circC (102circF), an increase from 37.0circC (98.6circF).
Which action should the nurse take first?
- Stop the transfusion and disconnect the blood tubing at the catheter hub.
- Flush the IV line with 0.9% normal saline to maintain patency.
- Slow the rate of the transfusion and notify the healthcare provider.
- Administer the prescribed PRN dose of acetaminophen for the fever.
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