Blood Products

Question 1

Blood and Blood Products

Answer 1

1) increase intravascular volume, replace clotting factors and components of blood, replace blood loss, and improve oxygen-carrying capacity
2) components:
- whole blood
- packed RBCs
- platelets
- plasma
- WBCs
- albumin

Question 2

Whole Blood:

action and therapeutic uses

Answer 2

1) pharmacological action:
- increases circulating blood volume
2) therapeutic uses:
- replacement therapy for acute blood loss secondary to traumatic injuries or surgical procedures
- volume expansion in clients with extensive burn injury, dehydration, or shock

Question 3

Packed RBCs:

action and therapeutic uses

Answer 3

1) pharmacological action:
- increases number of RBCs
2) therapeutic uses:
- severe symptomatic anemia (Hgb < 6 g/dL)
- hemoglobinopathies
- medication-induced hemolytic anemia
- erythroblatosis fetalis

Question 4

Platelet Concentrate:

action and therapeutic uses

Answer 4

1) pharmacological action:
- increases platelet count
2) therapeutic uses:
- thrombocytopenia (platelet count < 20,000/mm3)–aplastic anemia, chemotherapy-induced bone marrow suppression
- active bleeding (platelet count < 80,000 mm3)

Question 5

Type of Reaction

Answer 5

1) acute hemolytic
2) febrile nonhemolytic
3) anaphylactic
4) mild allergic
5) circulatory overload
6) sepsis

Question 6

Complications:

side/adverse effects and nursing interventions/client education

Answer 6

1) acute hemolytic reaction:
- chills
- fever
- low back pain
- tachycardia
- tachypnea
- hypotension
2) febrile nonhemolytic reaction, most common (sudden chills); fever (increase in temperature greater than 1 degree from baseline); headache

1) stop the transfusion immediately if symptoms occur, and notify the provider
2) observe for S&S of a reaction and stop the transfusion if they occur
3) notify the provider immediately and follow facility policy regarding resumption or discontinuation of transfusion
4) administer acetaminophen (Tylenol) for fever

Question 7

Complications:
side/adverse effects and
nursing interventions/client education

Answer 7

1) anaphylactic reactions
- anxiety
- urticaria
- wheezing
- shock
- cardiac arrest
2) mild allergic reactions
- flushing
- itching
- urticaria

1) if symptoms occur, stop the transfusion and notify the provider immediately
2) initiate CPR if necessary
3) have epinephrine ready for IM or IV injection
4) if symptoms are very mild and there is not respiratory compromise, antihistamines may be prescribed. Then, restart the transfusion slowly.

Question 8

Complications:
side/adverse effects and
nursing interventions/client education

Answer 8

1) circulatory overload
- cough
- crackles
- SOB
- hypertension
- tachycardia
- distended neck veins

1) observe clients for S&S of fluid volume excess
2) if symptoms occur, stop the transfusion and notify the provider immediately
3) place the client upright with feet down
4) administer diuretics and oxygen as appropriate
5) monitor I&O
6) a slower rate of infusion may be indicated

Question 9

Complications:
side/adverse effects and
nursing interventions/client education

Answer 9

1) sepsis
- rapid onset of chills and fever
- vomiting
- diarrhea
- hypotension
- shock

1) observe clients for S&S during and following transfusion
2) notify the provider immediately if symptoms occur
3) obtain blood culture, send blood transfusion bag for analysis for possible contaminants, and treat sepsis with antibiotics, IV fluids, vasopressors, and steroids