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

Blood Administration Flashcards

Review blood types, administration, and complications.

1
Q

What is a blood type and screen?

A
  • 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.

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2
Q

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

A

For active bleeding or the client has a very low hemoglobin and hematocrit level.

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3
Q

Why would a client get a blood transfusion of platelets?

A

To treat thrombocytopenia or platelet disorders.

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4
Q

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

A

To replace clotting factors due to a clotting factor disorder.

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5
Q

Which clients would get an infusion of granulocytes?

A

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
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6
Q

What are the 4 blood types?

A
  1. Type A
  2. Type B
  3. Type AB
  4. Type O
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7
Q

Complete the sentence:

Type O is the universal ________.

A

donor

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

Remember the O in dOnor.

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8
Q

Complete the sentence:

Type AB is the universal _________.

A

recipient

This client can receive blood from any blood type.

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9
Q

Type A can get blood from which other blood types?

A

A or O

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10
Q

Type B can get blood from which other blood types?

A

B or O

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11
Q

Type AB can get blood from which other blood types?

A

A, B, AB or O

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12
Q

Type O can get blood from which other blood type?

A

Type O

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13
Q

What is Rh, Rh positive and Rh negative?

A

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

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14
Q

Can an Rh negative client receive Rh positive blood?

(Immediate Complication)

A

No. The client can die.

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

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15
Q

Can a Rh positive client receive Rh negative blood?

A

Yes.

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16
Q

What are the steps to giving a blood product?

A
  1. verify order from the HCP
  2. start IV line with normal saline 0.9%
  3. get the blood from the blood bank
  4. get the tubing ready with the blood product and normal saline (but don’t hook it up to the patient yet)
  5. verify the client and blood product/blood type with another RN
  6. get a set of baseline vital signs
  7. hook up the tubing and start the blood transfusion
  8. stay with the client to assess for any reactions
  9. take another set of vital signs in 15 minutes (or hospital policy requirements)
  10. document
17
Q

What type of IV fluid is compatible with blood?

A

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

18
Q

What gauge needle is given with blood?

A

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.

19
Q

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
A
20
Q

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

A
  • The Y tube is to mix the blood with normal saline
  • The filter is to filter out blood clots, clumps of platelets and white blood cells
21
Q

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

A

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

22
Q

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

A

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

23
Q

Over how long should 1 unit of blood be given?

A

Within 4 hours.

24
Q

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

A
  • 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
25
Q

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

A

For the first 15 minutes, to monitor for transfusion reactions.

26
Q

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

A

2 Registered Nurses will confirm:

  • correct client
  • blood type and Rh factor of the client
  • correct blood product and blood type
27
Q

What is a hemolytic blood transfusion reaction?

(Immediate Complication)

A

When there is an incompatibility with the blood product that causes the red blood cells to get destroyed.

28
Q

What is an allergic blood transfusion reaction?

(Immediate Complication)

A

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.

29
Q

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

(Immediate Complication)

A

When there is bacteria in the blood that causes a systemic infection.

30
Q

How is septicemia treated when acquired from a blood transfusion?

(Immediate Complication)

A
  • 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
31
Q

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

A
  • fever
  • chills
  • urticaria (hives)
  • itching (pruritis)
32
Q

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

A
  • acetaminophen for fever
  • diphenhydramine for itching

Give meds 30 minutes before starting blood transfusion.

33
Q

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

(Immediate Complication)

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

Antibodies are attacking the red blood cells causing decreased oxygen.

34
Q

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

(Immediate Complication)

A
  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
35
Q

What causes circulatory overload from a blood transfusion?

A
  • The blood is being administered too quickly
  • The client has renal, heart or liver failure and cannot tolerate the extra fluids
36
Q

How is circulatory overload prevented when giving a blood transfusion?

A
  • Give the blood product at a slower rate
  • Assess for signs of fluid volume overload
37
Q

How can a blood transfusion cause hypocalcemia?

A

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

38
Q

How can a blood transfusion cause hyperkalemia?

A

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

NCLEX-RN (1) Fundamentals (17 decks)

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