Blood Transfusions

Question 1

Two reasons for a blood transfusion

Answer 1

Internal Bleeding and External Bleeding

Question 2

Number one cause of an upper GI bleed

Answer 2

esophageal varices

Question 3

Who is prone to esophageal varices?

Answer 3

alcoholism

Question 4

Why may a patient be presenting with low RBCs?

Answer 4

cancer, anemia, GI bleeds

Question 5

What happens if a patient has high RBCs?

Answer 5

the blood will thicken

Question 6

What is the primary complaint for someone with low RBCs?

Answer 6

SOB

Question 7

What is the primary complaint of someone who has low platelet levels?

Answer 7

bruising

Question 8

Where are clotting factors made?

Answer 8

liver

Question 9

When would someone have low plasma levels?

Answer 9

liver failure or burn victims

Question 10

How would someone with low plasma levels present?

Answer 10

Altered mentation, lethargy, low BP, high HR

Question 11

Why would a person have issues clotting?

Answer 11

Vitamin K deficiency, Factor V leiden deficiency, hemophilia

Question 12

What does albumin do?

Answer 12

pulls fluid back into vasculature to help recirculate it

Question 13

What is something that is absolutely necessary before a blood transfusion?

Answer 13

consent

Question 14

Who gets consent and who witnesses it if a patient is given a blood transfusion?

Answer 14

Doctor explains, Nurse witnesses

Question 15

What is important info to gather prior to a transfusion?

Answer 15

baselines!! (vitals, labs, mentation, etc.)

Question 16

Hgb level indicative of a transfusion

Answer 16

less than 8

Question 17

What gauge of needle is ideal for blood transfusions?

Answer 17

at least 20 gauge

Question 18

If you don’t have a needle big enough for a transfusion, what can you do to ensure the RBCs won’t lyse?

Answer 18

Slow the rate

Question 19

How long can blood sit out before a transfusion?

Answer 19

up to 1 hour

Question 20

How many times can you use the blood transfusion tubing?

Answer 20

twice

Question 21

What kind of solution is the only one that can be used to prime tubing in a blood transfusion?

Answer 21

normal saline only!!

Question 22

Why can’t LR be used as the fluid for a blood transfusion?

Answer 22

calcium in LR

Question 23

When should reactions be monitored during a transfusion?

Answer 23

within first 15 minutes

Question 24

How quickly should a blood transfusion be done?

Answer 24

minimum 1 hour

Question 25

How do you know what rate to transfuse blood?

Answer 25

orders should state the time

Question 26

What is the purpose of the filter in the blood transfusion tubing?

Answer 26

filter out microclots

Question 27

How often are vital signs taken in the first 15 minutes of transfusion?

Answer 27

every 5 minutes

Question 28

What is the first vital sign to change if there is an adverse reaction to a transfusion?

Answer 28

temperature increase

Question 29

What are signs of an anaphylactic reaction to a blood transfusion?

Answer 29

urticaria, wheezing, shock

Question 30

What drug is given if anaphylactic shock occurs during transfusion?

Answer 30

epinephrine

Question 31

What is associated with low back pain?

Answer 31

bases of the lungs

Question 32

Signs of acute hemolysis during a transfusion

Answer 32

chills, fever, low back pain, tachycardia, tachypnea, hematuria, ↓BP, ARF

Question 33

Minimum liters for a non-rebreather mask

Answer 33

10-15L

Question 34

What should be done if the patient is experiencing any adverse side effects during the transfusion?

Answer 34

stop the tranfusion

Question 35

Steps for nursing management of any adverse side effects during a blood transfusion

Answer 35

stop transfusion, disconnect transfusion set, flush the line, notify MD/initiate appropriate orders, treat symptoms, notify blood bank, send transfusion work-up, document

Question 36

What should be given to a patient with pulmonary edema?

Answer 36

lasix combined with nitroglycerin and bipap