Difficulty: Medium
Average Score: 68%
Full-length
The nurse is caring for a hospitalized adult who is receiving a blood transfusion. Twenty minutes after the start of the transfusion, the client complains of feeling cold and is shivering. What is the best first action for the LPN to take?
Correct answer
D
Rationale
Shivering and feeling cold during a transfusion suggest a possible transfusion reaction, requiring immediate cessation of the transfusion to prevent further complications, followed by vital signs and physician notification.