Blood administration

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  1. Transfusion Therapy
    injection/administration of blood or blood products into the blood stream
  2. Rh Factor
    an antigen that is a component of the RH blood groups and is made up of numerous complex antigens.
  3. Rh+
    indicates person has Rh factor on surface of RBCs

    Rh+ person may be transfused with either Rh- Rh+ blood
  4. Rh-
    indicates person does not have Rh factor on surface of RBCs

    person may only be transfused with Rh- blood to prevent formation of antibodies to Rh+ blood.
  5. Blood typing
    blood test that determines blood type
  6. Crossmatching
    blood test that indicates compatibility between blood of donor and recipient.
  7. Packed RBCs are supplied in _____mL bags
    250 mL
  8. Packed RBCs
    a concentrated source of RBCs and are the most common component given to RBC-deficient patients.
  9. Packed RBCs are used for pts who
    patients who have a hemoglobin level less than 8 g/dL or who are hypoxemic.
  10. Compatibility is determined by two different antigen systems (cell surface proteins):
    the ABO system antigens and the Rh antigen, present on the membranes of RBCs.
  11. Platelet Transfusions
    • are given to patients with platelet counts below 10,000 mm3
    • to patients with thrombocytopenia who are actively bleeding
    • or are scheduled for an invasive procedure.
  12. Single donor platelets
    • taken from just one donor and decrease the amount of antigen exposure to the recipient, helping prevent the formation of platelet antibodies.
    • The chances of allergic reactions to future platelet transfusions are thus reduced.
  13. For patients who are going to receive a hematopoietic stem cell transplant (HSCT) or who need multiple platelet transfusions,
    single-donor platelets may be prescribed.
  14. Platelet infusion bags usually contain
    300 mL for pooled platelets and 200 mL for single-donor platelets
  15. Platelets are fragile and must be infused immediately after being brought to the patient's room, usually over a
    15- to 30-minute period
  16. For a platelet transfusion take vital signs
    • before the infusion,
    • 15 minutes after the infusion starts,
    • and at its completion.
  17. What is given to reduce the chances of a reaction in a platelet transfusion
    diphenhydramine (Benadryl) and acetaminophen (Tylenol)
  18. A pt can have febrile and have rigors (severe chills) during transfusion, but these symptoms
    are not a true transfusion reaction.
  19. Plasma transfusions
    may be given fresh to replace blood volume
  20. Fresh Frozen Plasma (FFP)
    plasma is frozen immediately after donation

    Freezing preserves the clotting factors, and the plasma can then be used for patients with clotting disorders
  21. Infuse FFP
    immediately after thawing while the clotting factors are still active.
  22. Who are candidate for FFP??
    Patients who are actively bleeding with a prothrombin time (PT) or partial thromboplastin time (PTT) greater than 1.5 times normal
  23. ABO compatibility is
    required for transfusion of plasma products.
  24. Plasma infusion bag contains
  25. Infuse FFP as
    rapidly as the patient can tolerate, generally over a 30- to 60-minute period, through a regular Y set or straight-filtered tubing.
  26. Cryoprecipitate
    a product derived from plasma.

    Clotting factors VIII and XIII, von Willebrand's factor, and fibrinogen are precipitated from pooled plasma to produce cryoprecipitate.
  27. who are candidates for cryoprecipitate
    Patients with a fibrinogen level of less than 100 mg/dL
  28. cryoprecipitate can be infused, but it is usually given by
    IV push within 3 minutes. Dosages are individualized, and it is best if the cryoprecipitate is ABO compatible.
  29. Febrile transfusion reactions
    occur most often in the patient with anti-WBC antibodies, a situation that can develop after multiple transfusions.

    develops chills, tachycardia, fever, hypotension, and tachypnea
  30. How can you reduce a Febrile transfusion reaction
    • Giving leukocytereduced blood or single-donor HLA-matched platelets reduces the risk for this type of reaction.
    • WBC filters may be used to trap WBCs and prevent their infusion into the patient.
  31. Hemolytic transfusion reactions
    • caused by blood type or Rh incompatibility.
    • When blood containing antigens different from the patient's own antigens is infused, antigen-antibody complexes are formed in his or her blood.
  32. Hemolytic transfusion actual reactions to the body
    • The reaction may be mild, with fever and chills, or life threatening, with disseminated intravascular coagulation (DIC) and circulatory collapse. Other manifestations include:
    • •Apprehension
    • •Headache
    • •Chest pain
    • •Low back pain
    • •Tachycardia
    • •Tachypnea
    • •Hypotension
    • •Hemoglobinuria
    • •A sense of impending doom
  33. The onset of a hemolytic reaction may be
    immediate or may not occur until subsequent units have been transfused.
  34. Allergic transfusion reactions
    • are most often seen in patients with a history of allergy.
    • They may have urticaria, itching, bronchospasm, or anaphylaxis.
  35. The onset of an Allergic reaction
    usually occurs during or up to 24 hours after the transfusion
  36. Patients with a history of allergy can be given
    • leukocytereduced or washed RBCs in which the WBCs and plasma have been removed.
    • This procedure reduces the possibility of an allergic reaction.
  37. Bacterial transfusion reactions
    Bacterial transfusion reactions
  38. Symptoms of Bacterial transfusion reactions are
    include tachycardia, hypotension, fever, chills, and shock
  39. The onset of a Bacterial transfusion reaction is
  40. Circulatory overload
    can occur when a blood product is infused too quickly.

    This complication is most common with whole-blood transfusions or when the patient receives multiple transfusions.

    Older adults are more at risk

    • Increase HOB, stop transfusion, IV NSS to
    • KVO, notify MD,
  41. Circulatory overload Symptoms include
    • •Hypertension
    • •Bounding pulse
    • •Distended jugular veins
    • •Dyspnea
    • •Restlessness
    • •Confusion
  42. How can you manage and prevent circulatory overload
    monitoring intake and output, infusing blood products more slowly, and giving diuretics
  43. Transfusion-associated graft-versus-host disease (TA-GVHD)
    a rare but life-threatening problem that can occur in both immunosuppressed and immunocompetent patients.

    Its cause in immunosuppressed patients is similar to that of GVHD that occurs with allogeneic stem cell transplantation, in which donor T-cell lymphocytes attack host tissues.
  44. Sepsis
    Due to contaminated blood components and when blood sits around too long

    Fever, chills, possible shock

    Stop blood, NSS to KVO, notify MD, blood bag and tubing sent back to lab
  45. Acute Hemolytic
    Most dangerous – blood is usually incompatible

    Chills, back pain, chest tightness leading to shock, renal failure, vascular collapse and cardiac arrest

    Can occur after only 10 ml of blood

    • Discontinue blood – emergency
    • fluids/drugs/dialysis to maintain renal and blood pressure

    Treat shock

    Red urine appears on next void – collect urine

    Collect blood specimen
  46. Delayed Hemolytic Reaction
    Occurs days to weeks after infusion – usually less severe

    Fever, malaise, gradual decrease in H/H

    No red urine

    Important to monitor because may be a precursor to a more severe reaction in further transfusions
  47. Hyperkalemia reactions
    Prolonged storage of blood, cell destruction, improper handling

    blood cells get destroyed
  48. Hypocalcemia reactions
    Preservative used to store blood binds with calcium to cause a deficiency.
  49. Diseases transmitted by blood transfusions



    Lyme Disease
  50. The nurse is administering PRBCs. The pt is
    experiencing dypnea, crackles in the lungsbases and an increasin BP. The nurse can anticipate the physician to do
    Lasix 40 mg IV push
Card Set
Blood administration
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