Final: Anemia and Blood Transfusions

Question 1

Administer blood within _________________ of receiving from blood bank

Answer 1

30 minutes

Question 2

Key points about blood administration

Answer 2

Verify client’s ID
Check provider’s order
Check labels on blood bag and blood bank transfusion record
Baseline vitals (then per policy)
#18G or #20G needle
Normal saline IV solution
Blood administration set with filter
Severe reactions most likely within first 15 mins and first 50cc
Blood tubing changed after 4 hours

Question 3

What precautions do you use when handling blood products?

Answer 3

Universal precautions

Question 4

Blood transfusion reaction: Priorities

Answer 4

Stop transfusion and notify provider immediately
Administer 0.9% NSS through new tubing
Document start and stop time of transfusions, how much blood product was infused?
Monitor VS and urinary output
Notify blood bank, recheck ID tag, send blood and tubing to blood bank
Obtain urine specimen, insert indwelling catheter to monitor urine output

Lab work: Repeat type and cross match, CBC, bilirubin

Question 5

Packed RBCs

Answer 5

Purpose: Increase RBCs, Severe anemia, hemoglopinopathies, anaphylactic reactions

Question 6

Whole blood

Answer 6

Purpose: Increase blood volume, traumatic injuries, surgical blood loss, shock, burns

Question 7

Epoetin Alfa

Answer 7

Treatment of anemia associated with renal failure and AIDs, decreased needs for blood transfusions in patients undergoing surgery

Contraindications: Uncontrolled hypertension, allergy to mammalian cell-derived or human albumin, lactation

Adverse effects: Hypertension, edema, possible chest pain, headache, fatigue, asthenia, dizziness, seizure, n/v/d

Question 8

Ferrous sulfate (oral)

Answer 8

Elevates serum iron concentration, iron deficiency anemias

Contraindications: Allergy, hemochromatosis, hemolytic anemia, normal iron balance, peptic ulcer, colitis, regional enteritis

Adverse effects: GI irritation, CNS toxicity, constipation (may need stool softener**

Drug-drug: GI meds (antacids, cimetidine, cholestyramine), antibiotics “- floxacin”

Take with vitamin C/food with vitamin C, no milk or tea, take on empty stomach if tolerated

Question 9

Folic acid (Leucovorin)

Answer 9

Folate deficiencies

Caution: Other anemias

Adverse effects: Pain/discomfort at injection site, nasal irritation with intranasal spray

Drug-drug: Decrease phenytoin levels

Question 10

Vitamin B12
Cyanocobalamin
Hydroxocobalamin

Answer 10

Pernicious anemia

Adverse effects: Pain/discomfort at injection site, erythema, itching, rash, nausea, diarrhea

Don’t take with aspirin

Caution: Hypokalemia