Blood Transfusions Flashcards
After blood is received when should the blood be initiated? and completely administered?
30min; 4hrs
What is needed prior to requesting a blood product from the blood bank?
An order from the physician, informed consent, pre-transfusion VS and are acceptable and venous access site is adequate
How do you verify the product?
Order w/ product, verify w/ 2 licensed staff members and read aloud to each other the typecross match, unit #, exp. date, compatibility on tag and any special requirements, pt ID band/pre-meds
What must remain attached to the unit for the duration of the transfusion?
Transfusion tag
If a pt. doesn’t have a name band what is done?
Blood product is returned to the blood bank immediately
How often should you check VS, this includes lung sounds?
Q15min for the 1st hour then every hour after that including postop
When is the bottom half of the tag completed?
If a reaction occurred
What should be documented?
Date/time upon completion of transfusion, volume of blood product (I/O), peripheral/central line appearance, any complications
What is the term used to describe the complication where a transfusion of incompatible red cells cause red cell destruction?
Hemolytic reaction
What is the term used to describe the condition where a rise in the pt’s temp rises to even 1 degree above their baseline?
Febrile reaction
What is the term used to describe pt’s having a pre-formed sensitivity to certain plasma proteins that may be present in the donor blood leading to a mild to severe reaction?
Allergic reaction
What is the term used to describe a complication that can occur w/ only a few ml of blood transfused and can proceed to life-threatening shock?
Anaphylactic reaction
What is the term used to describe a complication that occurs from a high/rapid volume infusion to pt’s w/ compromised cardiac or pulmonary status?
Circulatory overload
Name this reaction: chills, fever, HA, flushing, chest pain, pain in lower back, resp. difficulties, drop in BP?
Hemolytic reaction
Name this reaction: Urticaria (hives), fever, edema, itching, chills?
Allergic reaction
Name this reaction: chills, fever, HA, flushing, tachycardia?
Febrile reaction
If a febrile reaction occurs what should you do?
Stop transfusion, notify doc/blood bank, d/c IV tubing from IV site, hang NS 500-1000ml @ a min. of 20cc/hr w/ new tubing, check bag, obtain STAT blood sample results should be w/in 30min, restart blood if febrile or return to blood bank if other reaction
Name this reaction: acute resp. distress, bronchospasm, loss of consciousness, N/V, abd cramps, diarrhea?
Anaphylactic reaction
Name this reaction: pulmonary edema, dyspnea, CHF, HA, HTN, cyanosis?
Circulatory overload
If a reaction other than a febrile reaction occurs what should you do?
Stop transfusion, keep IV access open, hang NS w/ new tubing @ 20cc/hr, take VS, verify product/pt, notify doc/blood bank, complete bottom half of tag and send to blood blank and document
What should the PICC line be?
4 French 18 gauge or larger
Where should you dispose of blood bag/tubing?
Biohazard bag
When are whole bloods used?
In emergency situations
What decreases the risk of fluid overload and reactions to plasma proteins?
PRBCs
What contains all clotting factors except platelets?
FFP
What is always included in VS when giving a transfusion?
Breath/lung sounds
How should you begin the blood transfusion?
Slowly 5ml/min to assess for a reaction
What should you do other than stop transfusion if a pt has an allergic reaction?
May give an antihistamine prophylatically, run NS and contact physician to determine if blood should be d/c’d
What should you do other than stop transfusion if a pt has a fluid overload reaction?
Place upright, give diuretics/oxygen, monitor for worsening respt. status and I/O
What should you do other than stop transfusion if a pt has a febrile reaction?
Monitor temp, may give antipyretics prophylatically
What should you do if a hemolytic reaction occurs?
Stop transfusion, maintain IV access w/ NS, notify doc/blood bank, save blood bag/tubing, collect urine/blood samples, anticipate emergency procedures
What are normal creatinine levels?
0.8-1.4
What are normal BUN levels?
8-23
What are normal hemoglobin levels?
12-16 women
14-18 men
What are normal hematocrit levels?
42-52 men
37-47 women
What are normal WBC levels?
4.5-10
What are normal platelet levels?
150-400
How much does 1 unit of PRBC increase BUN by?
1
What should you do if there is drainage from the NG tube?
Guaiac