If a client reports chills and back pain while receiving packed RBCs, what should the nurse do first?

In the context of this situation, when a client experiences chills and back pain during a packed RBC infusion, the immediate priority is to stop the infusion of blood. This action is crucial for several reasons.

First, these symptoms may indicate a potential transfusion reaction, which can be serious and requires prompt intervention to prevent further complications. Stopping the infusion halts the introduction of any possibly harmful substances into the bloodstream and minimizes the risk of severe reactions that could occur if the transfusion continues.

Furthermore, the nurse is responsible for monitoring the patient’s condition and ensuring their safety. By stopping the blood transfusion right away, the nurse can assess the symptoms more closely and begin necessary interventions, such as providing supportive care and ensuring the patient remains stable.

Once the infusion is stopped, appropriate follow-up actions, such as notifying the healthcare provider and potentially obtaining urine samples for laboratory analysis, can be initiated. However, the priority in this situation is to prevent any further harm to the client, making the cessation of the blood transfusion the first critical step.