A nurse preceptor is observing a newly licensed nurse preparing to administer a blood transfusion to an older adult. Which action indicates understanding?

• A. Inserts an 18-gauge IV catheter in the client
• B. Verifies blood compatibility and expiration date of the blood with an assistive personnel
• C. Administers dextrose 5% in 0.9% sodium chloride
• D. Obtains vital signs every 15 min throughout the procedure

Answer: (D)

Frequent monitoring during a blood transfusion is essential to catch adverse reactions early. Obtaining vital signs every 15 minutes throughout the transfusion demonstrates you’re prioritizing safety and can detect problems as soon as they begin. Most acute transfusion reactions occur early, so this close monitoring allows you to stop the transfusion promptly and notify the provider if symptoms appear (fever, chills, dyspnea, flushing, flank or chest pain, hypotension, tachycardia). In older adults, with reduced physiologic reserve, such vigilant observation is particularly important to prevent rapid deterioration.

Other aspects matter, but this action best shows understanding of transfusion safety in practice. For example, IV access is important, but simply choosing a large-bore catheter doesn’t guarantee safety without ongoing monitoring. Verifying compatibility and expiration should be done by licensed staff, not assistive personnel. And blood products are infused with normal saline, not dextrose-containing solutions, to avoid hemolysis. The ongoing vital signs monitoring directly reflects the most critical safety step in the transfusion process.