NU 300 EXAM 3 – RESPIRATORY PROBLEMS AND INFUSION THERAPY |
COMPREHENSIVE MEDICAL-SURGICAL NURSING STUDY GUIDE 2026/2027
isotonic - correct answer ✔✔Has same osmolality as body fluids; can cause increased risk for fluid
overload
hypotonic - correct answer ✔✔Can exacerbate a hypotensive state
Fluid shifts into cells
0.45% NS
hypertonic - correct answer ✔✔Irritating to the vein; can cause increased risk of heart failure and
pulmonary edema
Fluid from cells into vascular space
3% NS
blood transfusions - correct answer ✔✔Blood type OO
receives from O ONLY
universal donor
Blood type AB
universal receiver
donates to AB only
Blood type AA, AO
receives from AA, AO, OO
donates to AA, AO, AB
Blood type BB, BO
receives from BB, BO, OO
donates to BB, BO, AB
delegation and collaboration of infusion therapy - correct answer ✔✔The task of initiating transfusion
therapy cannot be delegated to nursing assistive personnel (NAP)
The nurse instructs NAP about:
Frequency of vital sign monitoring needed
What to observe, such as complaints of shortness of breath, hives, and/or chills, and reporting this
information to the nurse
Obtaining blood components from the blood bank (if agency permits)
risk reduction (blood transfusion) - correct answer ✔✔Type and Cross:
2 people verify
72 hrs
Autologous or directed donations
, 2 RN verification
Timing:
30 minutes to hang
4 hrs to administer
Monitoring:
VS: Pre/15 min/1 hr/2hr/3hr/4hr/post
Stay with patient for first 15 minutes
Administration:
Tubing
2mL/min (120 mL/hr) start
Only 0.9% NS
Y-set aka blood set - correct answer ✔✔Blood tubing
Good for 4 hrs
Spike one side with blood
Spike one side with NS- Prime line with NS, flush after transfusion with NS
Monitoring for Adverse Transfusion Reactions - correct answer ✔✔Adverse reactions may occur at any
time during transfusion
Life-threatening reactions usually occur within the first 15 minutes of transfusion
Remain with a patient during this time to monitor physiological responses
Some patients experience a delayed transfusion reaction days or weeks later
Transfusion Reactions - correct answer ✔✔Febrile
Sensitivity to donor, leukocytes, or platelets
MOST COMMON
S/S:
>1 C increase from baseline temp
Chills
Flushing
H/A
INTERVENTIONS:
Stop transfusion
Antipyretics
Monitor temp q4
Leukocyte-reduced in future
Hemolytic
ABO/Rh incompatibility
Acute or delayed
S/S:
Chest/flank/low back pain
Increased HR
Fever
Chills
COMPREHENSIVE MEDICAL-SURGICAL NURSING STUDY GUIDE 2026/2027
isotonic - correct answer ✔✔Has same osmolality as body fluids; can cause increased risk for fluid
overload
hypotonic - correct answer ✔✔Can exacerbate a hypotensive state
Fluid shifts into cells
0.45% NS
hypertonic - correct answer ✔✔Irritating to the vein; can cause increased risk of heart failure and
pulmonary edema
Fluid from cells into vascular space
3% NS
blood transfusions - correct answer ✔✔Blood type OO
receives from O ONLY
universal donor
Blood type AB
universal receiver
donates to AB only
Blood type AA, AO
receives from AA, AO, OO
donates to AA, AO, AB
Blood type BB, BO
receives from BB, BO, OO
donates to BB, BO, AB
delegation and collaboration of infusion therapy - correct answer ✔✔The task of initiating transfusion
therapy cannot be delegated to nursing assistive personnel (NAP)
The nurse instructs NAP about:
Frequency of vital sign monitoring needed
What to observe, such as complaints of shortness of breath, hives, and/or chills, and reporting this
information to the nurse
Obtaining blood components from the blood bank (if agency permits)
risk reduction (blood transfusion) - correct answer ✔✔Type and Cross:
2 people verify
72 hrs
Autologous or directed donations
, 2 RN verification
Timing:
30 minutes to hang
4 hrs to administer
Monitoring:
VS: Pre/15 min/1 hr/2hr/3hr/4hr/post
Stay with patient for first 15 minutes
Administration:
Tubing
2mL/min (120 mL/hr) start
Only 0.9% NS
Y-set aka blood set - correct answer ✔✔Blood tubing
Good for 4 hrs
Spike one side with blood
Spike one side with NS- Prime line with NS, flush after transfusion with NS
Monitoring for Adverse Transfusion Reactions - correct answer ✔✔Adverse reactions may occur at any
time during transfusion
Life-threatening reactions usually occur within the first 15 minutes of transfusion
Remain with a patient during this time to monitor physiological responses
Some patients experience a delayed transfusion reaction days or weeks later
Transfusion Reactions - correct answer ✔✔Febrile
Sensitivity to donor, leukocytes, or platelets
MOST COMMON
S/S:
>1 C increase from baseline temp
Chills
Flushing
H/A
INTERVENTIONS:
Stop transfusion
Antipyretics
Monitor temp q4
Leukocyte-reduced in future
Hemolytic
ABO/Rh incompatibility
Acute or delayed
S/S:
Chest/flank/low back pain
Increased HR
Fever
Chills
