The nurse is reviewing the client's medical record. Exhibits The nurse is ready to assist with administering the blood transfusion. For each potential nursing action, click to specify if the action is indicated or not indicated.

Document the blood product transfusion in the client's medical record.

Monitor the client for the first 15 min of the transfusion.

Assist with obtaining the first unit of packed RBCS from the blood bank.

Assist with titrating the rate of infusion to maintain the client's blood pressure at 90/60 mm Hg or above.

Start an IV bolus of lactated Ringer's solution.

Discard the blood bag in the client's trash can after the transfusion.