blood component therapy Flashcards
blood types and compatibility ***
O- universale donor
AB+ universal recipient
if positive you can have + and -
if negative you can only have -
AB can have A, B, AB, O
O can only have O
A can only have A, O
B can only have B, O
O blood ***
has no antigens
if its negative then it has no RH antigens as well
PRBCs ***
indications:
Hgb less than 7
expected outcome:
increased oxygenation
less fatigue
reach homeostasis
use filter tubing
only give wirth 0.9% NS (NO MEDS)
2-4 hours
platelets ***
contain only platelets (no clot factors)
use:
*thrombocytopenia
expected outcome:
*increase plt
*decrease bleeding
FFP: fresh frozen plasma ***
liquid portion of blood
contain clot factors
indications:
*liver failure
*conditions with lack of clotting factor
albumin ***
requires vented IV tubing
use:
*hypovolemic shock
*hypoalbuminemia
does not require type/cross match
SE: cell dehydration, FVE, edema, pulmunary edema
pretransfusion ***
ensure venous access (22g or larger for adults)
informed consent
type/cross done
basline VS, physical exam
2 RN double check required
hang within 30 min of leaving blood bank
use Y tubing connected to a bag of NS (no other fluids)
transfusion ***
slow transfusion first 15 mins (5ml/min)
VS:
*pretransfusion
*15 min into transfusion
*then q1hr
must transfuse within 4 hours
transfusion reactions
febrile (most common) ***
fever
tachycardia
tx:
stop transfusion and call provider
tranfusion reactions
hemolytic reaction ***
blood incompatibility
fever/chills
flank pain
dyspnea
hematuria
*can progress into shock
tx:
stop transfusion and call provider
oxygen/airway concern
tranfusion reactions
allergic reaction ***
urticaria (hives)
itching
flushing
tx:
stop transfusion and call provider
*usually give antihistamine and RESTART
tranfusion reactions
Transfusion-associated circulatory overload (TACO) ***
bascially FVE
risk:
*CHF, older adults, CKD
*run it more slow
*nurse decided the rate
management:
sit them up if have SOB
tranfusion reactions
nursing interventions ***
stop transfusion
maintain pt IV with NS
assess pt
notify blood bank/MD
blood goes back to blood bank
*expect blood/urine collection
tranfusion reaction delegation
RN
place and assess IV
check pt ID with blood product
adjust transfusion rates
assess and evaluate for signs of transfusion rachtion and therapeutic effects
tranfusion reaction delegation
LPN/LVN
assist with checking blood
monitor transfusion rate
