HELP with this question, please!

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"A 39 year old man is admitted wit ha diagnosis of AIDS. Lab results" Hgb 9.3, Hct 25%, plates 100,000, WBC 1,500. Which of the following should the nurse implement FIRST?:

a)Infuse 2 units PRBC

b)place pt on neutropenic precautions

Correct Answer is B. I picked A b/c according to Kaplan, if both are implementations then go to Maslow and ABC (circulation-infusing PRBC would take priority over infection was my thought process.) His Hbg and HCT are low AS ARE his WBC, but why the neutropenic first? In fact, where there was a different question abotu Toxic Shock, the choices were to either give ABX first or hook up and run 0.9%NS. Correct answer in this case was 0.9%NC....so isn't this kind of the same concept with the AIDS question?

any thoughts appreciated!:)

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You can't make a decision to infuse PRBC's without a doctor's order. So, as a nurse, "b" is the only correct answer.

steph

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I'd pick B because it doesn't really take any time to instill neutropenic precautions...it won't delay your administration of PRBCs.

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Specializes in FNP, Peds, Epilepsy, Mgt., Occ. Ed.

A hemoglobin of 9.3 is low, but not life-threatening. The neutropenia could very well be life-threatening. Putting him on precautions immediately could do a lot to help protect him from infection.

I've seen patients leave the hospital with a hgb of not much over 9.3, after transfusion.

In the toxic shock example, the fluids needed to start first to prevent circulatory collapse.

It boils down to: which would kill the patient first???

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I still think it is as simple as we can't, on our own, decide to hang blood.

But then those NCLEX questions are so darn frustrating . . .

steph

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The point is sweetie715, stop learning the kaplan strategy it's very confusing. Trust me, it's no help on the NCLEX-RN. It's better if you use expected outcomes and rationales for doing a procedure. Sometimes the strategy help confuse and make a question wrong. It's better to trust in your skills and what you know about nursing.

For example, in the question the main thing is prevention and infection needs to be prevented from further complications. Remember, I can do all things throught Jesus Christ who strengthens me

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Specializes in Telemetry/Med Surg.
I still think it is as simple as we can't, on our own, decide to hang blood.

But then those NCLEX questions are so darn frustrating . . .

steph

I agree with you there, Steph.

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