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ATI blood and blood product transfusions 3100 test 2
Terms in this set (26)
Whole blood or components of blood can be transfused for clients who require replacement due to blood loss or blood disease.
blood from donors is used.
The clients blood is collected.
Clients may donate blood 5 weeks in advance up to 72 hours prior to surgery.
Intraoperative blood salvage
Blood loss during certain surgeries can be recycled through a cell saver machine and transfused intraoperatively or postoperatively.
Indications for transfusion
Excessive blood loss- whole blood.
Anemia- packed RBCs.
Kidney failure- Packed RBCs.
Coagulation deficiencies, ie, hemophilia- fresh frozen plasma.
Thrombocytopenia/platelet dysfunction- platelets.
Incompatibility is a major concern when administering blood or blood products, and preventing incompatibility requires strict adherence to blood transfusion protocols.
Blood type A
Antibodies against B.
Compatible with A and O.
Blood type B
Antibodies against A.
Compatible with B and O.
Blood type AB
No antibodies .
Compatible with A,B, AB and O.
Blood type O
Antibodies against A and B.
Compatible with O.
Blood that cotains D antigen makes the Rh factor positive.
Rh positive blood given to an Rh negative person will caue hemolysis.
*Assess lab values, such as Hgb and Hct. Packed RBCs are usually prescribed for clients who have an Hgb less than 8g/dL.
*Verify the prescription for a specific blood product.
*Obtain blood samples for compatibility determination, such as type and crossmatch.
*Initiate IV access. A 20 guage needle is standard for administering blood products.
*Assess the client for a history of blood transfusion reactions.
*Obtain blood products from the blood bank. Inspect the blood for discoloration, excessive bubbles, or cloudiness.
*Following facililty protocol, confirm the clients identity, blood compatibility, and expiration of the time of the blood product with another nurse.
*Prime the blood administration set with 0.9% sodium chloride. Blood products are infused only with 0.9% sodium chloride. Never add medications to the blood products.
* Use a filter, Y-tubing.
*Obtain the clients baseline vital signs.
*begin the transfusion, and use a blood warmer if indicated.
*Explain to the client the reason for the blood transfusion.
*Stay with the client for the first 15 to 30 minutes of the infusion. (reactions occur most often in the first 15 min)
*vital signs then every hour afterward.
*rate of infusion
*sudden increase in anxiety
*Notify the provider immediately if indications of a reaction occur.
*Complete the transfusion within 2-4 hours to avoid bacterial growth.
*Assess vital signs more frequently, because changes in pulse, blood pressure, and respiratory rate may indicate fluid overload, or may be indicators of a transfusion reaction.
*Older adult clients who have cardiac or renal dysfunction are at an increased risk for heart failure and fluid-volume excess when receiving a blood transfusion.
*Obtain vital signs.
*Dispose of blood administration set appropriately.
*Monitor blood values as prescribed (CBC, Hgb, Hct).
*Hgb values should rise by 1g/dL with each unit transfused.
*Document clients response.
*May be mild or life threatening
*Chills, fever, low back pain, tachycardia, flushing, hypotension, chest tightening or pain, tachypnea, nausea, anxiety, hemoglobinuria.
*May cause cardiovascular collapse, kidney failure, disseminated intravascular coagulation, shock, death.
*30 minutes to 6 hours after transfusion.
*Chills, fever, flushing, headache, anxiety.
*Use WBC filter.
*during or up to 24 hours after transfusion.
*itching, urticaria, flushing,
*administer antihistamines, ie, diphenhydramine (Benadryl).
*wheezing, dyspnea, chest tightness, cyanosis, hypotension.
*maintain airway, administer oxygen, IV fluids, antihistamines, corticosteroids, vasopressors.
*stop the procedure.
*initiate an infusion of 0.9% sodium chloride.
*the infusion should be intiated with a seperate line, so as not to infuse more blood from the transfusion tubing.
*save the blood bag with the remaining blood and the blood tubing for testing at the lab.
*explain to the client the reason the transfusion is being discontinued.
*clients who have impaired cardiac function can experience circulatory overload as a result of a transfusion.
*dyspnea, chest tightness, tachycardia, tachypnea, headache, hypertension, jugular-vein distension, peripheral edema, othopnea, sudden anxiety, and crackles in the base of the lungs.
*administer oxygen, monitor vital signs, slow the infusion rate, and administer diuretics as prescribed.
*notify the provider immediately.
Sepsis and septic shock
*Fever, nausea, vomiting, abdominal pain, chills, hypotension.
*maintain patent airway and administer oxygen.
*administer antibiotic therapy as prescribed.
*obtain samples for blood cultures.
*administer vasopressors (raise BP), ie, dopamine, to combat vasodilation inthe late phase.
*elevate the clients feet.
DIC disseminated intravascular coagulation
*administer anticoagulants, ie. heparin, in the early phase.
*administer clotting factors and blood products during the late phase (clotting factors are depleted in the early stage).
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