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What equpment for administration of blood products
- 1. Tubing with filter
- 19 gauge need for venous access
Adverse reactions to packed red blood cells
1. Reactions are less common with whole blood
Nursing considerations for Packed Red Blood Cells
- Companion solution 0.9% NaCl
- Use Standard Blood Filter
- Mix cells everyon 20-30 minutes ( sqeeze) bag
- Give over 2-4 hours
Adverse reaction of Platelets
some febrile reactions
Nursing considerations for platelets?
- 1. companion solution 0.9% NaCl
- 2. Nonwetable filter
- 3. Give quickly as possible ( 4 unit/hour)
Adverse reactions to Albumin
Possible circulatory overload
Nursing consierations for albumin?
- Use administration set provided
- 25% albumin give at 1ml/min
- give as quickly as possible for somone in shock
Advers reaction to plasma?
Nursing considerations for Plasma?
- 1. Administer with a staight line set
- 2. Give as quickly as possible ( coagulations factors become unstable)
10. Prothrombin adverse reactions?
- Hepatitis risk greater than with whole blood
- allergic/febrile reaction
Adverse reactions of factor VIII
allergic and febrile reactions
Nursing considerations for Prothrombin?
1. Use straight line set
Nursing considerations for factor VIII
Use component drip set or syring
Type O can recieve from?
Type A can be a donor for?
Type B can recieve blood from?
AB can recieve blood from?
Procedure for administering blood
- A. Have blood product
- B. Tubing and filter
- C. 19 gauge needle for venous access
- 2. Type and crossmatch to make sure compatible
- 3. Check blood for bubbles , dark color,or cloudiness
- 4. Ask client aobut allergies or pervious blood reactions
- 5. Check with two nurses
- a. Physicians order
- b. Pt's identity
- c.Hosptial ID band name and number
- d. Blood component tag
- e. blood type and RH
- 6. Check basline vitals, including temp
- 7. Start with normal saline (0.9% NaCL)
- 8.. Run blood slowly for 15 min
- 9. Stay with patient for 15-30min
- 10. Recheck vital signs 15 min after infusion has started
- 11. No untoward effects, incrase rate, should be infulsed in 2 hours for each unit ( depending on patients cardio status)
- 12. Take vital signs every hour until completed, then hourly q 3
- 13. For elderly check vital signs every 15 min throughout transfusion
- 14 . For elderly infuse unit over 3-4 hours
- 15. Ask patient to report itching of flank pain over kidneys
- 16. Change entire IV line for each unit of blood
What to do if transfusion reaction is suspected?
- 1. stop blood or blood product
- 2. Restart normal saline
- 3. Save blood container and tubing and return to blood bank
- 4. Draw blood sample for plasma, hemoglobin, culture, retyping
- 5. Collect urine sample and send to lab for hemoglobin determination
- 6. Monitor voiding for hematurian
24. Considerations for Autologous transfustion
- 1. Preoperative donation 4-6 wks before surgery
- 2. Iron supplements may be ordered
Benifets to autologous transfuion
- Prevention of viral infections from donated blood
- Used for clients with history of transfustion reactions
- Rare blood type
Autologous is contra for?
- Acute infection
- Chronic disease
- Hemoglobin < 11g/L
- Cerebrovascular disease
- Cardivascular disease
What is the cause of a Allergic Reaction
Hypersensitivity to anitbodies in donors blood
What is the symptoms of an allergic reaction?
- 1. Occurs immediatley within 24 hours
- 2. Mild-uticari, itching and flushing
- 3. Anaphalaxis
- 4 Hypotension
- 5. Dyspnea, decreased o2 sat, flushing
What are nursing consideration in an allergic reaction
- 1. prevention premedicate with anithistamines
- 2. Stop the blood
- 3. Restart with 0.9% NaCl
- 4. Notify physician
- 5. Supportive care: benadryl, oxygen, coricosteroids
Cause of hemolytic reaction?
Symptoms of hemolytic reaction?
- 1. Occurs within minutes to 24 hours
- 2. Nausea, vommiting, low back pain
- 3. hypotension, increased pulse rate
- 4. decrease in urinary output, hematuria
Nursing consideration in acute hemolytic reaction?
- 1. STOP blood!
- 2. Supportivie care: oxygen, benadryl, airway management
Cause of febrile reaction?
Antibodies to donor platelets or leukocytes
Symptoms of febrile reactions?
- occurs in minutes to hours
- fever, chills, nausea, headace, flushing,
- tachycardia, palpatations
Nursing considerations for febrile reactions?
- 1. STOP BLOOD!
- 2. Suportive care
- Aslo is seen in patient with multiple transfustions
Cause of Bacterial infection with blood transfusion
Syptoms of bacterial reaction?
- Occurs within minutes to <24 hours
- fever, chills, shock
Nursing consideration with bacterial reaction
- 1. STOP BLOOD
- 2. Obtain blood culture
- 3. Antibiotirics, IV fluids, vasopressors, sterioids
Cause circulatory overload?
large volume over short time
Symptoms of circulatory overload
- occurs within minutes to hours
- crackles, increased resp rate
- tacky cardia
Nursing consideration fluid overload
- 1. Monitor those at risk ( elderly, heart disease, children)
- 2. Slow, or D/C transfusion