The following statement is true regarding transfusion of blood to a hemodynamically stable adult patient:

Appeared in: GMCH - 2016

Explanation

The standard and safe time limit for infusing one unit of packed red blood cells or whole blood is a maximum of 4 hours.
This rule is primarily to minimize the risk of bacterial proliferation in the blood product once it is removed from controlled temperature storage and is at room temperature.
Extending the transfusion beyond 4 hours significantly increases the risk of the patient developing a septic reaction from bacterial contamination.

Option A: This infusion rate (10 mL/min) is too fast for the initial observation period. The first 15 minutes are critical for detecting adverse reactions.
Option B: This statement suggests a minimum duration of 6 hours, which is incorrect and dangerous. The maximum allowed time is 4 hours.
Option D: Warming blood at the bedside is an unsafe practice that can lead to hemolysis and bacterial growth. Blood is administered at room temperature or warmed with specialized equipment.

Clinical Relevance

Nursing practice connection: Use the key finding related to Blood Transfusion Safety Protocols to guide bedside assessment, documentation, and the next nursing action.
Adherence to the 4-hour rule is a fundamental patient safety measure in nursing practice to prevent transfusion-associated sepsis.
The nurse is responsible for monitoring the start and end times of the transfusion and ensuring the infusion rate is adjusted to meet this deadline without causing fluid overload.
What if? If a patient develops a fever, chills, or rash 10 minutes into the transfusion, the nurse's immediate action is to stop the transfusion, disconnect the blood tubing, and keep the IV line open with normal saline. This is a sign of a potential transfusion reaction that requires immediate intervention and reporting.

How to Approach the Question

This is a factual recall question about a standard clinical procedure.
First, identify the core concept: safety guidelines for blood transfusion.
Recall the critical parameters for blood administration: initiation time, infusion rate (especially the initial rate), total duration, and temperature management.
Evaluate each option against these standard protocols.
Option A deals with the initial rate. Is 150 mL in 15 minutes a slow, safe start? No.
Option B deals with total duration. Is a minimum of 6 hours correct? No, the maximum is 4 hours.

Concept Tested & Keywords

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E6 Nursing Fundamentals Taylor p. 830-832

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 775-777

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1132-1134

Practise the full GMCH - 2016

Attempt every question from this paper in a timed mock, then review the full solution for each one.