護理師準備執行輸血。哪項行動對於預防輸血反應至關重要？
A nurse is preparing to administer blood products. Which action is essential to prevent a transfusion reaction?
- AVerify client identity and blood type with another nurse✓ 正解與另一位護理師共同驗證客戶身分與血型
- BUse an IV set with a 10-micron filter使用具有10微米濾器的IV管路
- CAdminister the blood over 6 hours to prevent overload在6小時內緩慢輸血以防止過載
- DWarm the blood in the microwave for rapid infusion在微波爐中加熱血液以快速輸注
輸血屬於高風險醫療程序，最嚴重的併發症是急性溶血性輸血反應（Acute Hemolytic Transfusion Reaction），通常源於病人與血袋身分核對錯誤（ABO 血型不相容）。根據病人安全目標（National Patient Safety Goals），輸血前必須由兩位合格護理人員在床邊進行雙人核對，確認病人姓名、出生日期、血袋編號、血型與交叉試驗報告。這項機制旨在消除人為錯誤，確保「正確的血給正確的病人」。其他選項皆違反安全準則：微波會導致血液過熱破壞紅血球；輸血過慢增加細菌生長風險；濾網孔徑過小會導致溶血。
Transfusion is a high-risk medical procedure, and the most serious complication is an acute hemolytic transfusion reaction, usually resulting from misidentification between client and blood unit (ABO incompatibility). According to the National Patient Safety Goals, two qualified nurses must perform a bedside two-person verification before transfusion, confirming the client's name, date of birth, blood unit number, blood type, and cross-match report. This mechanism is designed to eliminate human error and ensure the right blood goes to the right patient. The other options violate safety standards: microwaving overheats the blood and destroys red cells; transfusing too slowly increases the risk of bacterial growth; and a filter with too small a pore size causes hemolysis.
在美國，輸血前的雙人核對必須在床邊（bedside）進行，且兩位核對者皆需在醫囑單或電子病歷上記錄簽名，是非常嚴格的法律規範（Legal requirement）。