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NCLEX-RN (1) Fundamentals > Blood Administration > Flashcards

Flashcards in Blood Administration Deck (37)
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1

What is a blood type and screen?

  • Blood typing is determining the blood type and Rh factor of a sample of blood
  • A screen is looking for the most commonly found unexpected antibodies

The results of this test are good for 72 hours.

2

Why would a client need a blood transfusion of packed red blood cells (PRBCs)?

Packed red blood cells (PRBCs) are for active bleeding or the client has a very low hemoglobin and hematocrit level.

3

Why would a client get a blood transfusion of platelets?

Platelets are to treat thrombocytopenia or platelet disorders.

4

Why would a client get an infusion of fresh-frozen plasma?

An infusion of fresh frozen plasma is to replace clotting factors due to a clotting factor disorder.

5

Which clients would get an infusion of granulocytes?

Granulocytes are to boost the immune system for:

  • a client with sepsis (systemic infection)
  • neutropenic client that is unresponsive to antibiotics
    • usually for clients getting chemo

6

What are the 4 blood types?

The 4 blood types are:

  1. Type A
  2. Type B
  3. Type AB
  4. Type O

7
Complete the sentence:

Type O is the universal ________.

Type O is the universal donor (remember the O in dOnor).

Anyone can receive type O blood (as long as the Rh factor is appropriate).

8
Complete the sentence:

Type AB is the universal _________.

Type AB is the universal recipient.

This client can receive blood from any blood type.

9

Type A can get blood from which other blood types?

Type A can get type A or O.

10

Type B can get blood from which other blood types?

Type B can get type B or O.

11

Type AB can get blood from which other blood types?

Type AB can get A, B, AB or O.

12

Type O can get blood from which other blood type?

Type O can only get type O.

13

What is Rh, Rh positive and Rh negative?

Rh is a protein on red blood cells:

  • if you have it, you're Rh positive
  • if you don't have it, you're Rh negative

14
Immediate Complication

Can an Rh negative client receive Rh positive blood?

No. The client can die.

Rh positive blood will make antibodies against the Rh negative client and destroy the red blood cells.

15

Can a Rh positive client receive Rh negative blood?

Yes

16

What type of IV fluids is compatible with blood?

Normal saline, 0.9% - that's it, nothing else.

17

What gauge needle is given with blood?

Blood administration needs a larger gauge lumen such as 18 or 19.

This is to prevent the red blood cells from breaking as they go through the IV catheter.

18

Label the parts of blood tubing:

  • blood bag
  • blood information (Rh, ABO group, expiration date, ID number)
  • drip chamber
  • filter
  • normal saline bag
  • roller clamp

19

Why is there Y tubing and a filter for blood tubing?

  • The Y tube is too mix the blood with normal saline
  • The filter is too filter out blood clots, clumps of platelets and white blood cells

20

To get blood into the filter chamber should you squeeze it?

Never, you can damage the filter. Let it fill up from gravity.

21

How long should blood be started after receiving it from the blood bank?

Start the blood product within 30 minutes of receiving it from the blood bank.

22

Over how long should 1 unit of blood be given?

Give 1 unit of blood within 4 hours.

23

How often are vital signs taken when blood is being administered?

Vital signs are taken:

  • right before the blood is started
  • 15 minutes after it's started (unless the client shows symptoms - get vital signs earlier)
  • at least every 30 minutes to 1 hour until it's finished
  • a final set of vital signs after the infusion is completed

24

How long should the nurse stay with the client once the blood transfusion is started?

Stay with the client for the first 15 minutes to monitor for transfusion reactions.

25

Who verifies the client and blood product right before the blood is started?

2 Registered Nurses will verify the blood product. They will confirm:

  • correct client
  • blood type and Rh factor of the client
  • correct blood product and blood type

26
Immediate Complication

What is a hemolytic blood transfusion reaction?

A hemolytic reaction is when there is an incompatibility with the blood product that causes the red blood cells to get destroyed

27
Immediate Complication

What is an allergic blood transfusion reaction?

An allergic reaction is when there is an incompatibility with the blood product that causes an allergic response such as mild itching to severe anaphylaxis.

28
Immediate Complication

What is a febrile/bacterial/septic blood transfusion reaction?

A febrile/bacterial/septic reaction is when there is bacteria in the blood that causes a systemic infection.

29
Immediate Complication

How is septicemia treated when acquired from a blood transfusion?

Treatment for septicemia from a blood transfusion:

  • get blood cultures of the blood and blood bag
  • give O2
  • IV fluids
  • antibiotics
  • vasopressors: to increase the blood pressure from septic shock
  • steroids: to decrease inflammation

30

What are the signs and symptoms of a mild blood transfusion reaction?

Signs and symptoms of a mild blood transfusion reaction:

  • fever
  • chills
  • urticaria (hives)
  • itching (pruritis)

31

What medications are commonly given before a blood transfusion starts for a client that has had a mild allergic reaction in the past?

For mild blood transfusion reactions give:

  • acetaminophen for fever
  • diphenhydramine for itching

Give meds 30 minutes before starting blood transfusion.

32
Immediate Complication

What are life-threatening signs and symptoms of a blood transfusion reaction?

Signs and symptoms of a serious blood transfusion reaction:

  • respiratory distress, dyspnea, dizziness, shortness of breath
  • chills, diaphoresis
  • back or chest pain

Antibodies are attacking the red blood cells causing decreased oxygen.

33
Immediate Complication

What are the steps if there's a reaction to a blood transfusion?

Steps to a blood transfusion reaction:

  1. FIRST: stop the blood transfusion
  2. change out the tubing, but keep the IV line in
  3. start a new bag of normal saline, 0.9%
  4. tell the HCP and blood bank
  5. return the blood and tubing to the blood bank
  6. stay with the client
  7. may have to give epinephrine for severe symptoms such as difficulty breathing

34

What causes circulatory overload from a blood transfusion?

Circulatory overload can be caused by:

  • the blood is being administered too quickly
  • the client has renal, heart or liver failure and cannot tolerate the extra fluids

35

How is circulatory overload prevented when giving a blood transfusion?

Prevent circulatory overload:

  • give the blood product at a slower rate
  • assess for signs of fluid volume overload

36

How can a blood transfusion cause hypocalcemia?

Hypocalcemia is caused by a preservative in the blood binding with calcium and being excreted

37

How can a blood transfusion cause hyperkalemia?

Hyperkalemia is caused by old blood causing potassium to be released from cells