Practical Procedures

Question 1

What needs to be done before blood can be ordered?

Answer 1

Group and save x2

Or crossmatch

Question 2

What do you need to check on the patient before blood transfusion?

Answer 2

Cannula: pink/green/grey/orange
Signs of infection around cannula?
Date of insertion

Do baseline obs before blood transfusion

Check wristband, request form, pt verbally and blood bag ID

Question 3

Explain the procedure of blood transfusion

Answer 3

Explain to patient, consent, check ID and prescription
G&S x2 Request blood
Check cannula pink or above, no signs of infection, in date
Do baseline obs on patient and explain SE need to be reported to nurse straight away (hot, dizzy, headache, nausea, pain)

Check blood ID, pt ID, form ID
Check blood expiry date and for imperfections- check with another healthcare professional

Attach blood giving set and remove air form tubing
Clean cannula and let air dry
Flush cannula with saline, attach blood
Give over 3 hrs
Obs at 15m, 30m then hrly and at end of transfusion
Sign and date paperwork

Question 4

What should you state when explaining blood transfusion

Answer 4

Blood should be given within 30mins of leaving refrigerator
Always check details with another healthcare professional before giving blood
If >1 bag of blood, pt may need 20mg furosemide IV between doses to avoid fluid overload

Question 5

What equipment do you need for an NG tube placement?

Answer 5

NG tube, drainage bag, gloves, apron, dressing/tape, pH strip, syringe, glass of water and straw

Question 6

How do you know which size NG tube?

Answer 6

Measure nose-tragus-xiphisternum

Question 7

What pH is acceptable for NG tube aspirate and what do you do if not able to aspirate or pt on PPI?

Answer 7

pH 5.5 and below is acceptable
If above 6 may need CXR
If already feeding via NG, wait 1 hr to re-aspirate and test pH
Check tube not coiled in mouth

Question 8

What are you looking for in a CXR to confirm position of NG tube?

Answer 8

Tube descends in the midline (slightly to left)
Bisects carina
Moves slightly to left and perforates diaphragm
10cm below gastro-oesophageal junction

Question 9

Explain how to set up for catheterisation

Answer 9

WIPE, chaperone?
Assemble equipment
Wiped down trolley, 12/14F catheter, catheter pack, sterile gloves, sterile water x2, gauze/cotton wool, instillagel, collection bag
Attach bin to side of trolley
Create sterile area and unpackage equipment
Wear sterile gloves & empty 1xsterile water into tub, open instillagel and put gel on tray
Make hole in sterile sheet and place it ver penis/labia

Question 10

Where is the urethra located in females?

Answer 10

Below the clitoris, above the vaginal orifice

Within the labia minora

Question 11

Name 5 acute transfusion reactions

Answer 11

Immune: TRALI, anaphylaxis, ABO incompatibility (acute haemolytic)
Non immune: TACO, bacterial infection

Question 12

Name 5 delayed transfusion reactions

Answer 12

Immune: Febrile non haemolytic, delayed haemolytic, post transfusion purpura, graft vs host
Non immune: viral/malaria/prion infection