Which action is essential to perform before initiating a blood transfusion?

• A. Ask family for consent.
• B. Inspect the IV line.
• C. Obtain baseline vital signs by a licensed nurse.
• D. Administer an antihistamine if requested by the prescriber.

Answer: (C)

Before initiating a blood transfusion, establish the patient’s starting status. Recording baseline vital signs gives a reference point to detect early signs of a transfusion reaction, such as fever, an increased heart rate, or dropping blood pressure, as soon as they occur. A licensed nurse is responsible for obtaining these vitals and for ongoing monitoring during the transfusion, which is a crucial safety measure. While consent and ensuring IV access are important steps in the process, they do not provide the immediate monitoring data that baseline vitals do. Inspecting the IV line is necessary to ensure patency, but it doesn’t establish the patient’s initial condition. Prophylactic antihistamines aren’t routinely indicated unless specifically ordered, and could mask early reaction symptoms.