The nurse is preparing to administer thawed plasma to a client with active bleeding and multiple coagulation-factor deficiencies. Which action is appropriate?
1Add the client's scheduled antibiotic to the plasma bag so both therapies can run through one line.
2Verify the client and component, use filtered blood tubing with compatible saline, and monitor for reactions.✓ Correct answer
3Dilute the plasma with dextrose solution before administration to reduce the risk of fluid overload.
4Leave the plasma at the bedside until it reaches room temperature, then begin without baseline vital signs.
Explanation
Plasma is administered with standard blood-component safety procedures: verify the recipient and component according to policy, use appropriate filtered blood tubing and a compatible saline solution, begin promptly, and monitor the client for a transfusion reaction. Medications are not added to the component, dextrose is not used to dilute it, and unnecessary bedside delay increases risk.
Clinical reasoning Thawed plasma supplies multiple coagulation factors. It remains a blood component, so identification, compatibility, filtered administration equipment, and reaction surveillance are core safety controls.
Decision rule Verify before spiking, use the facility-approved filtered blood setup with compatible saline, start without unnecessary delay, and stop the transfusion immediately if a reaction is suspected.
Scenario Adult with coagulopathy (INR 3.5, active bleeding) receives FFP 1 unit. NS 0.9% available.
FFP (fresh frozen plasma) — All coagulation factors; for coagulopathy and rapid warfarin reversal.
Platelet transfusion — Room temperature; gently agitate; infuse over 30-60 min via filter.
Cryoprecipitate — Concentrated fibrinogen, factor VIII, vWF; for fibrinogen <100 or DIC.