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ahi > Care of Patients Receiving Blood Products > Flashcards

Care of Patients Receiving Blood Products Flashcards

1
Q

Red Blood Cells (RBC) or Packed Red Blood Cells (PRBC)
Platelets
Plasma or Fresh Frozen Plasma (FFP)
Granulocyte (White Blood Cells)

A

Types of transfusions

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2
Q

Typ packed - concentrated
To replace lost blood or anemia
Transplantation of tissues
Infuse over 2-4 hours
Use filtered pump tubing

A

Red Blood Cells

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3
Q

Compatibility is determined by 2 antigen systems - ESSENTIAL
ABO and Rh
**Donor and recipient blood must be checked carefully for compatibility

A

Transplantation of tissues

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4
Q

To treat thrombocytopenia or active bleeding: Platelets < 10,000 mm3
Platelets are pooled from multiple donors so do not have to have the same blood type
Use specific tubing: Longer tubing increases the chance that platelets will stick to lumen
Infuse over 15-30 minutes immediately

A

Platelets

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5
Q

To treat deficiency in plasma coagulation factors; elevated PT or PTT
Must be ABO compatible
Infuse over 15-30 minutes immediately after thawing:
So clotting factors are still active
Use Y set tubing

A

Plasma

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6
Q

Used with sepsis or neutropenic infection
Rare
More at risk for transfusion reactions: WBC surfaces have many antigens
Usually requires closer monitoring
Infuse over 1 hour

A

Granulocyte (WBC)

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7
Q

Assess labs and ensure need transfusion
Verify order with another RN
Ensure adequate venous access
Assess vital signs before get bloood
Obtain blood products from blood bank and administer as soon as possible
Safety checks - biggest priority
Inspect blood for discoloration, gas bubbles, cloudiness

A

Pretransfusion

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8
Q

Must be done by 2 RNs
One of the RNs has to also be responsible for administering the blood product
Verify patient’s identity with another RN
Examine blood bag label, attached tag, and requisition slip for ABO and Rh compatibility with the patient with another RN
Check expiration date with another RN

A

Safety checks - biggest priority

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9
Q

Could indicate hemolysis or bacteria

A

Inspect blood for discoloration, gas bubbles, cloudiness

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10
Q

Vital signs
Use appropriate tubing, filters and fluids
Begin transfusion slowly, stay with patient first 15 to 30 minutes
Ask patient to report unusual sensations
Administer blood product per protocol
Assess for hyperkalemia

A

During transfusion

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11
Q

immediately before starting infusion and again within the first 15-30 minutes

A

Vital signs

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12
Q

Never add or infuse anything with blood products
Prime tubing with Normal Saline (0.9% NS)

A

Use appropriate tubing, filters and fluids

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13
Q

chills, shortness of breath, hives, itching

A

Ask patient to report unusual sensations

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14
Q

Febrile Transfusion Reaction
Hemolytic Transfusion Reaction
Allergic (anaphylactic) Reaction
Bacterial Transfusion Reaction
Transfusion-Associated Circulatory Overload (TACO)
Transfusion related Graft v. Host disease
Acute Pain Transfusion Reaction (APTR)
Nursing Interventions

A

Complications

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15
Q

Acute
Signs:
Occurs when a patient has had multiple transfusions and develop WBC antibodies
Prevention:

A

Febrile Transfusion Reaction

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16
Q

Fever, chills, tachycardia, hypotension and tachypnea - check VS

A

Signs: - Febrile Transfusion Reaction

17
Q

Give leukocyte reduced blood or single donor blood
Use of WBC filters when administering blood products to filter out WBC

A

Prevention: - Febrile Transfusion Reaction

18
Q

Acute
Signs:
Occurs when there is a blood type or Rh incompatibility
Prevention:

A

Hemolytic Transfusion Reaction

19
Q

Fever, chills apprehension, HA, chest pain, low back pain, tachycardia, tachypnea, hypotension, sense of impending doom - VS

A

Signs: - Hemolytic Transfusion Reaction

20
Q

Antigen-antibody complexes form and destroy cells and cause inflammatory response

A

Occurs when there is a blood type or Rh incompatibility - Hemolytic Transfusion Reaction

21
Q

Ensure that all blood products and typed and crossmatched
Adhere to all safety checks prior to blood product administration

A

Prevention: - Hemolytic Transfusion Reaction

22
Q

Acute
Signs:
Usually seen in patients with other allergies
Prevention:

A

Allergic (anaphylactic) Reaction

23
Q

Urticaria, itching, bronchospasm, anaphylaxis - stop blood if receiving it

A

Signs: - Allergic (anaphylactic) Reaction

24
Q

Can occur immediately or within 24 hours

A

Usually seen in patients with other allergies - Allergic (anaphylactic) Reaction

25
Q

Give leukocyte reduced blood

A

Prevention: - Allergic (anaphylactic) Reaction

26
Q

Acute
Signs:
Caused by contaminated blood and onset is rapid

A

Bacterial Transfusion Reaction

27
Q

Tachycardia, hypotension, fever, chills

A

Signs: - Bacterial Transfusion Reaction

28
Q

Acute
Signs:
Occurs when blood product is infused too quickly
Fluid overload
Prevention:

A

Transfusion-Associated Circulatory Overload (TACO)

29
Q

Hypertension, bounding pulses, JVD, dyspnea, restlessness and confusion

A

Signs: - Transfusion-Associated Circulatory Overload (TACO)

30
Q

Infuse blood products slowly esp if high risk
Diuretics if dire enough and acute resp distress
Monitor I&O

A

Prevention: - Transfusion-Associated Circulatory Overload (TACO)

31
Q

Not acute; happens later
Bone marrow transplant pats
Signs:
Occurs in immunocompromised patients and occurs within 1-2 weeks - reacting to foreign tissue
Serious if not treated
Prevention:

A

Transfusion related Graft v. Host disease

32
Q

Thrombocytopenia, anorexia, N&V, weight loss, infection

A

Signs: - Transfusion related Graft v. Host disease

33
Q

Administered irradiated blood products that destroy T cells and cytokine

A

Prevention: - Transfusion related Graft v. Host disease

34
Q

Acute
Signs:
Rare and occurs during or immediately after transfusion
Treatment:

A

Acute Pain Transfusion Reaction (APTR)

35
Q

Severe chest pain, back pain, joint pain, hypertension, anxiety and redness of head and neck

A

Signs: - Acute Pain Transfusion Reaction (APTR)

36
Q

Control symptoms
Rigors - pain meds

A

Treatment: - Acute Pain Transfusion Reaction (APTR)

37
Q

Get VS and notify provider
Stop the infusion - first!!!!!
Take down all blood tubing and save with all labels - put in bag because investigation occurs
Oxygen - distress
Diphenhydramine (if allergic)
IV Fluids for severe shock
Antibiotics (if bacterial transfusion rxn if blood contaminated)
Antipyretics for fever - comfort
Meperidine for rigors

A

Nursing Interventions

38
Q

Don’t flush tubing and put anymore blood into the patient

A

Stop the infusion - first!!!!!

ahi (77 decks)

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