Blood Transfusions

Question 1

Universal Donor

Answer 1

O-

Question 2

Universal Recipient

Answer 2

AB+

Question 3

If a transfusion reaction is suspected, you should…

Answer 3

1. stop infusion
2. restart normal saline (with new tubing)
3. save blood container and tubing and return it to the blood bank
4. draw blood sample for plasma, hemoglobin, culture, retyping
5. collect urine sample for hemoglobin determination
6. monitor urine for hematuria

Question 4

Allergic reaction symptoms

Answer 4

cause: hypersensitivity to antibodies in donor’s blood
occurs: immediately or within 24 hours

mild symptoms: urticaria, itching, flushing
anaphylaxis: hypotension, dyspnea, decreased oxygen saturation, flushing

prevention: premedicate with antihistamines
supportive care: diphenhydramine, oxygen, corticosteriods

Question 5

Hemolytic reaction symptoms

Answer 5

cause: incompatibility
occurs: within minutes to 24 hours

symptoms: nausea, vomiting, fever, pain in lower back, hypotension, increase in pulse rate, decrease in urinary output, hematuria

supportive care: oxygen, diphenhydramine, airway management

Question 6

Febrile nonhemolytic rection (most common!)

Answer 6

cause: antibodies to donor platelets or leukocytes (seen in patients after multiple transfusions)
occurs: within minutes to hours

symptoms: fever, chills, nausea, headache, flushing, tachycardia, palpitations

supportive care: antipyretics (avoid aspirin in thrombocytopenic clients)

Question 7

Sepsis reaction

Answer 7

cause: contaminated blood products
occurs: within minutes to less than 24 hours

symptoms: tachycardia, hypotension, high fever, chills, shock

supportive therapy: antibiotics, IV fluids, vasopressors, steroids

Question 8

Circulatory overload reaction

Answer 8

cause: large volume over short period of time
occurs: within minutes to hours

symptoms: dyspnea, crackles, increased RR, tachycardia

Slow or d/c infusion