Before administering a transfusion of packed red blood cells, what essential check must be performed?

• A. Verify the patient’s kidney function
• B. Verify the patient’s hematocrit level
• C. Verify the patient’s blood type and donor compatibility
• D. Verify the admitting medical diagnosis

Answer: (C)

Ensuring compatibility between the patient and the donor blood is the key check. Packed red blood cells must be matched for ABO and Rh antigens to prevent a severe immune reaction. If a mismatch occurs, the recipient’s antibodies can attack the donor cells, leading to acute hemolysis, fever, chills, low blood pressure, kidney injury, and potentially death. In practice, a crossmatch is performed to confirm that the patient’s serum does not react with the donor red cells. The nurse then verifies the patient’s identity and that the unit labels and patient identifiers match, and checks the unit’s expiration date before starting the transfusion. Other checks like kidney function, hematocrit, or admitting diagnosis do not ensure transfusion safety.