blood transfusion Flashcards
why would you use washed RBC or leukocyte-reduced?
- history of allergic transfusion reactions
- hematopoietic stem cell transplant patients
what are washed RBC or leukocyte-reduced?
WBC, plasma, and immunoglobulin A have been reduced
this reduces the risk for an infection
what are the types of autologous transfusions?
- preoperative
- perioperative salvage
- postoperative salvage
benefits of autologous transfusions?
eliminates compatibility problems and reduces risk for transmitting bloodborne diseases
why isn’t whole blood given?
rarely given
- increase volume & increase chance for reaction
transfusion reaction types
- hemolytic
- febrile
- allergic (mild)
- allergic (severe)
- bacterial (sepsis)
- circulatory overload
transfusion reaction: circulatory overload
s/s & interventions
blood admin faster than circulation can accommodate
- cough, crackles (rales), distended neck veins
- sit up w/feet dependent
- slow/stop infusion
- admin diuretics/O2 as orderd
- notify MD
transfusion reaction:
bacterial (sepsis)
s/s & interventions
contaminated blood admin (r/f septic shock)
- high fever, vomiting, chills, hypotension
- stop transf
- notify MD
- admin IV fluid, antibiotics
- KVO w/NS (new tubing)
- send blood to lab
- pt blood cultures
transfusion reaction:
allergic reaction (severe)
s/s & interventions
antibody-antigen reaction (r/f shock & airway)
- dyspnea, facial swelling
- stop trans
- NS at KVO (new tubing)
notify MD - monitor VS
- CPR as needed
- admin meds/O2 as ordered
transfusion reaction:
allergic reaction (mild)
s/s & interventions
SENSITIVITY to transfused plasma protein
- itching, urticaria, flushing, wheezing
- slow or stop infusion
- notify MD
- antihistamines/benadryl
- NS KVO
transfusion reaction:
febrile reaction
s/s & interventions
sensitivity to WBCs, platelets, or plasma protein
- fever, flushed skin, muscle pain
- stop infusion
- antipyretics (fever)
- notify MD
- KVO w/NS
transfusion reaction:
hemolytic reaction
s/s & interventions
incompatibility between clients blood & donor’s blood, common first 15min, (delay=milder), can lead to shock
- cyanosis, chest pain, tachycardia, hypotension, backache
- strop trans, new tubing
- notify MD
- KVO w/NS, 10ml hr
- send blood pack & pt sample to lab
- monitor VS, I&O
gerontological considerations for IV access
- veins prone to scarring
- loss of tugor
- vasoconstriction
- easy rupture/bruising
gerontological considerations for systemic reactions
- prevent fluid volume overload
- consider hx CHF, renal insuff.
- monitor fluid & electro balance, edema, resp insuff
goals/evals from trans
- RBC count
- h+h
- platelet count
- clotting factors
- relief from clinical manifestations
