Blood Administration and Transfusion Reactions

Question 1

requirements to donate blood

Answer 1

weight at least 110 lbs
be at least 17 years old
temp less than 99.6

Question 2

types of blood donations

Answer 2

• directed: blood given for a specific person
• standard: blood given to anyone
• autologous: gives blood for self for later potential blood loss, can be saved for 10 years
• intraoperative blood salvage: blood is removed, filtered, and given back (unclosed system)
• hemodilution: intraoperative (closed system)

Question 3

complication of donating blood

Answer 3

vagus syncope

Question 4

universal donor

Answer 4

O-

Question 5

universal recipient

Answer 5

AB+

Question 6

pre-transfusion assessment

Answer 6

• previous reaction?
• received blood products?
• pregnancies?
• vital signs
• physical assessment

Question 7

s/s of transfusion reaction

Answer 7

chills
fever
respiratory distress
low back pain
nausea
pain at iv site
unusual feeling

Question 8

pre-transfusion procedure

Answer 8

• check written orders
• educate patient
• check id, name, and blood type (verified by two nurses)
• check the expiration date
• obtain second verifier to check blood info at the bed site in front of patient
• second nurse co-signs transfusion record
• label specimen at the bedside
• obtain vitals
• assessment

Question 9

how to administer blood products

Answer 9

• use y-type tubing with a 170-260 micro-aggregate filter
• make sure tubing is primed with normal saline ONLY
• take vitals, begin transfusion
• stay with pt for at least the first 15 minutes

Question 10

nursing management during reactions

Answer 10

• stop transfusion
• assess
• notify primary provider and implement prescribed treatment
• continue to monitor
• return blood
• obtain any samples
• document

Question 11

post-transfusion procedure

Answer 11

• obtain vital signs
• dispose blood administration set appropriately
• monitor blood values as prescribed
• complete necessary post-transfusion paperwork
• document (if pt on i&o, total blood volume should be accounted for intake)

Question 12

types of transfusion complications

Answer 12

• febrile nonhemolytic reaction
• acute hemolytic reaction
• allergic reaction
• circulatory overload
• bacterial contamination
• transfusion-related acute lung injury
• delayed hemolytic reaction
• disease acquisition
• long-term transfusion therapy

Question 13

febrile nonhemolytic reaction

Answer 13

• caused by antibodies to donor wbc that remain in the unit of blood or blood component
• usually occurs 2 hours after start of transfusion

Question 14

acute hemolytic reaction

Answer 14

• most dangerous
• occurs from incompatibility within first 10cc of blood transfused
• sx: fever, chills, low back pain, nausea, chest tightness, dyspnea, anxiety

Question 15

allergic reactions

Answer 15

• itching, flushing, urticaria

- histamine response

Question 16

circulatory overload

Answer 16

-too much products

Question 17

bacterial contamination

Answer 17

• can occur anytime during process

- blood has to be transfused within 4 hours because the warmer the blood is the more bacteria grows

Question 18

delayed hemolytic reaction

Answer 18

• can occur up to 14 days after the transfusion

- jaundice

Question 19

long-term transfusion therapy

Answer 19

occurs with multiple transfusion patients such as anemia and sickle cell patients

Question 20

pharmacologic alternatives to blood transfusions

Answer 20

• growth factors: increases the body’s production of blood cells
• erythropoietin: stimulates erythropoiesis for pt with chronic anemia
• granulocyte colony-stimulating factor: stimulates proliferation and differentiation of myeloid stem cells
• granulocyte- macrophage colony-stimulating factor: stimulates myelopoiesis
• thrombopoietin: increases platelet formation

Question 21

packed red blood cells

Answer 21

• needs to be transfused within 4 hours

- used for hemorrhage, surgery, trauma, burn, shock, anemia

Question 22

frozen RBC

Answer 22

• prepared from rbc using glycerol for protection and then frozen
• must be used within 24 hours of thawing
• used for autotransfusions: infrequently used because filters remove most of wbc

Question 23

platelets

Answer 23

• needs to be transfused for 15-30 minutes
• bag must be agitated
• used for bleeding caused by the inability to coagulate
• reactions: febrile, sepsis

Question 24

fresh frozen plasma

Answer 24

• liquid portion of whole blood
• transfuses for 30-60 minutes
• used for bleeding caused by deficiency in clotting factors
• reactions: acute hemolytic, febrile, mild allergic, hypervolemia, anaphylactic, sepsis

Question 25

albumin

Answer 25

• prepared from plasma
• available in 5% (1-10 ml/min) or 25% (4ml/min)
• used for hypoalbuminemia
• reaction: hypervolemia, pulmonary edema

Question 26

cyroprecipitates and commercial concentrates

Answer 26

• prepared form fresh frozen plasma

- used in treating hemophilia and for replacement of clotting factors, especially VIII and fibrinogen