Blood Administration and Transfusion Reactions Flashcards
(26 cards)
requirements to donate blood
weight at least 110 lbs
be at least 17 years old
temp less than 99.6
types of blood donations
- directed: blood given for a specific person
- standard: blood given to anyone
- autologous: gives blood for self for later potential blood loss, can be saved for 10 years
- intraoperative blood salvage: blood is removed, filtered, and given back (unclosed system)
- hemodilution: intraoperative (closed system)
complication of donating blood
vagus syncope
universal donor
O-
universal recipient
AB+
pre-transfusion assessment
- previous reaction?
- received blood products?
- pregnancies?
- vital signs
- physical assessment
s/s of transfusion reaction
chills fever respiratory distress low back pain nausea pain at iv site unusual feeling
pre-transfusion procedure
- check written orders
- educate patient
- check id, name, and blood type (verified by two nurses)
- check the expiration date
- obtain second verifier to check blood info at the bed site in front of patient
- second nurse co-signs transfusion record
- label specimen at the bedside
- obtain vitals
- assessment
how to administer blood products
- use y-type tubing with a 170-260 micro-aggregate filter
- make sure tubing is primed with normal saline ONLY
- take vitals, begin transfusion
- stay with pt for at least the first 15 minutes
nursing management during reactions
- stop transfusion
- assess
- notify primary provider and implement prescribed treatment
- continue to monitor
- return blood
- obtain any samples
- document
post-transfusion procedure
- obtain vital signs
- dispose blood administration set appropriately
- monitor blood values as prescribed
- complete necessary post-transfusion paperwork
- document (if pt on i&o, total blood volume should be accounted for intake)
types of transfusion complications
- febrile nonhemolytic reaction
- acute hemolytic reaction
- allergic reaction
- circulatory overload
- bacterial contamination
- transfusion-related acute lung injury
- delayed hemolytic reaction
- disease acquisition
- long-term transfusion therapy
febrile nonhemolytic reaction
- caused by antibodies to donor wbc that remain in the unit of blood or blood component
- usually occurs 2 hours after start of transfusion
acute hemolytic reaction
- most dangerous
- occurs from incompatibility within first 10cc of blood transfused
- sx: fever, chills, low back pain, nausea, chest tightness, dyspnea, anxiety
allergic reactions
- itching, flushing, urticaria
- histamine response
circulatory overload
-too much products
bacterial contamination
- can occur anytime during process
- blood has to be transfused within 4 hours because the warmer the blood is the more bacteria grows
delayed hemolytic reaction
- can occur up to 14 days after the transfusion
- jaundice
long-term transfusion therapy
occurs with multiple transfusion patients such as anemia and sickle cell patients
pharmacologic alternatives to blood transfusions
- growth factors: increases the body’s production of blood cells
- erythropoietin: stimulates erythropoiesis for pt with chronic anemia
- granulocyte colony-stimulating factor: stimulates proliferation and differentiation of myeloid stem cells
- granulocyte- macrophage colony-stimulating factor: stimulates myelopoiesis
- thrombopoietin: increases platelet formation
packed red blood cells
- needs to be transfused within 4 hours
- used for hemorrhage, surgery, trauma, burn, shock, anemia
frozen RBC
- prepared from rbc using glycerol for protection and then frozen
- must be used within 24 hours of thawing
- used for autotransfusions: infrequently used because filters remove most of wbc
platelets
- needs to be transfused for 15-30 minutes
- bag must be agitated
- used for bleeding caused by the inability to coagulate
- reactions: febrile, sepsis
fresh frozen plasma
- liquid portion of whole blood
- transfuses for 30-60 minutes
- used for bleeding caused by deficiency in clotting factors
- reactions: acute hemolytic, febrile, mild allergic, hypervolemia, anaphylactic, sepsis
