Which symptoms, if present in the patient receiving a blood transfusion, indicate the patient is experiencing an acute hemolytic transfusion reaction? Select all that apply.

The 21-year-old patient with a body mass index of 10.1 undergoes placement of a peripherally inserted central catheter (PICC) at 1000 and total parenteral nutrition (TPN) is initiated at 1200. At 1600, 160 mL have infused and the patient is noted to be breathing shallowly, there is blood oozing from the PICC insertion site, and the patient is exhibiting confusion. Which action does the nurse perform first? 

The nurse is asked to assist with a 38-year-old woman who desires oral birth control pills. The patient decides on an estrogen-progesterone formulation because she still desires to get her monthly periods. The patient states she is a heavy smoker. Which of the following is the most accurate statement about the smoking and this medication?