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What equpment for administration of blood products
- 1. Tubing with filter
- 19 gauge need for venous access
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Adverse reactions to packed red blood cells
1. Reactions are less common with whole blood
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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
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Adverse reaction of Platelets
some febrile reactions
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Nursing considerations for platelets?
- 1. companion solution 0.9% NaCl
- 2. Nonwetable filter
- 3. Give quickly as possible ( 4 unit/hour)
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Adverse reactions to Albumin
Possible circulatory overload
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Nursing consierations for albumin?
- Use administration set provided
- 25% albumin give at 1ml/min
- give as quickly as possible for somone in shock
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Advers reaction to plasma?
Ciruclatory overload
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Nursing considerations for Plasma?
- 1. Administer with a staight line set
- 2. Give as quickly as possible ( coagulations factors become unstable)
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10. Prothrombin adverse reactions?
- Hepatitis risk greater than with whole blood
- allergic/febrile reaction
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Adverse reactions of factor VIII
allergic and febrile reactions
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Nursing considerations for Prothrombin?
1. Use straight line set
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Nursing considerations for factor VIII
Use component drip set or syring
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Type O can recieve from?
O
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Type A can be a donor for?
-
-
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Type B can recieve blood from?
-
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AB can recieve blood from?
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Procedure for administering blood
- 1.
- 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
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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
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24. Considerations for Autologous transfustion
- 1. Preoperative donation 4-6 wks before surgery
- 2. Iron supplements may be ordered
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Benifets to autologous transfuion
- Prevention of viral infections from donated blood
- Used for clients with history of transfustion reactions
- Rare blood type
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Autologous is contra for?
- Acute infection
- Chronic disease
- Hemoglobin < 11g/L
- Cerebrovascular disease
- Cardivascular disease
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What is the cause of a Allergic Reaction
Hypersensitivity to anitbodies in donors blood
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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
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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
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Cause of hemolytic reaction?
Imcompatiblility
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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
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Nursing consideration in acute hemolytic reaction?
- 1. STOP blood!
- 2. Supportivie care: oxygen, benadryl, airway management
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Cause of febrile reaction?
Antibodies to donor platelets or leukocytes
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Symptoms of febrile reactions?
- occurs in minutes to hours
- fever, chills, nausea, headace, flushing,
- tachycardia, palpatations
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Nursing considerations for febrile reactions?
- 1. STOP BLOOD!
- 2. Suportive care
- Aspirin
- Aslo is seen in patient with multiple transfustions
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Cause of Bacterial infection with blood transfusion
Contaminated blood
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Syptoms of bacterial reaction?
- Occurs within minutes to <24 hours
- Tachycardia
- hypotension
- fever, chills, shock
-
Nursing consideration with bacterial reaction
- 1. STOP BLOOD
- 2. Obtain blood culture
- 3. Antibiotirics, IV fluids, vasopressors, sterioids
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Cause circulatory overload?
large volume over short time
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Symptoms of circulatory overload
- occurs within minutes to hours
- crackles, increased resp rate
- tacky cardia
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Nursing consideration fluid overload
- 1. Monitor those at risk ( elderly, heart disease, children)
- 2. Slow, or D/C transfusion
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