A health care provider prescribes two units of blood for a client. Which nursing interventions are necessary before the blood transfusion is administered?

• A. Obtain the client's vital signs.
• B. Monitor hemoglobin and hematocrit levels.
• C. Allow the blood to reach room temperature.
• D. Determine typing and crossmatching of blood.

Answer: (D)

Before giving blood, the most critical safety step is confirming compatibility through typing and crossmatching. Typing identifies the recipient’s ABO and Rh type, and crossmatching tests the recipient’s serum against the donor’s red cells to ensure there’s no reaction. When compatibility is confirmed, the risk of acute hemolytic transfusion reactions is greatly reduced. Other options describe helpful monitoring or handling practices, but they don’t address ensuring the donor blood will be safely accepted by the recipient’s immune system; vital signs and labs are important during and after transfusion, and letting blood come to room temperature is not a necessary or protective step.