Wk 2 Transfusion Reactions

Question 1

What should you do if you suspect a transfusion reaction?

Answer 1

Stop the transfusion, change the tubing and infuse just the NS

Question 2

What else should you do if you suspect your patient is having a blood transfusion reaction?

Answer 2

Assess patient
Notify blood bank and HCP
Recheck ID tag and numbers
Monitor VS and urine output

Question 3

When will urine output be effected during a blood transfusion reaction?

Answer 3

During a hemolytic reaction

Question 4

Most likely, the HCP will say what about a blood transfusion reaction?

Answer 4

Give them some Tylenol and resume the blood transfusion

Question 5

If your patient has a blood transfusion, you may be asked to do what?

Answer 5

Save the blood bag and send it back to the blood bank

Question 6

After a blood transfusion reaction occurs, what form should you fill out?

Answer 6

Transfusion reaction report form

Question 7

What is the most life threatening blood transfusion reaction?

Answer 7

Acute hemolytic reaction

Question 8

What is an acute hemolytic reaction?

Answer 8

Incompatibility of blood product

Question 9

What is a febrile, nonhemolytic reaction?

Answer 9

Fever develops during infusion

Question 10

What is a mild allergic reaction?

Answer 10

Sensitization of donor’s WBCs, platelets, or plasma proteins

Question 11

What is a severe reaction concerning allergies during a blood transfusion?

Answer 11

Anaphlyaxis

Question 12

What infection can be a blood transfusion reaction?

Answer 12

Bacteremia/sepsis

Question 13

What reaction is circulatory overload?

Answer 13

Too much blood volume administered

Question 14

What is another name for circulatory overload?

Answer 14

TACO

transfusion-associated circulatory overload

Question 15

Leukocytes in a blood product are considered

Answer 15

a contaminant and can cause adverse reactions

Question 16

Most blood in the United States is…

Answer 16

Pre-storage leukoreducted

Question 17

What are the signs and symptoms of acute hemolytic transfusion reaction

Answer 17

Immediate Onset
Facial flushing
Fever
Headache
Low back pain
Hemoglobinuria
Dyspnea, tachypnea
Hypotension
Cardiac arrest/death

Question 18

What do you do if your patient is experiencing a hemolytic reaction?

Answer 18

Treat shock, maintain BP with IV colloids

Question 19

What should you do concerning the kidneys if your patient had a hemolytic reaction?

Answer 19

Obtain first voided urine and insert foley to monitor I&Os

Question 20

What sample should you collect after a patient has a hemolytic reaction?

Answer 20

Blood sample from IV site

Question 21

What else will you send to the lab after a patient has a hemolytic reaction?

Answer 21

Unit, tubing, and filter

Question 22

What are the s/s of a non hemolytic febrile reaction?

Answer 22

Sudden chills and fever
Headache
Flushing 
Anxiety
Vomiting 
Muscle pain

Question 23

What will the provider most likely order for a patient experiencing a non-hemolytic febrile reaction?

Answer 23

Administer antipyretic

Restart the blood transfusion

Question 24

How can non-hemolytic febrile reactions be prevented?

Answer 24

Ensure patient is receiving leukocyte reduced products

Give Tylenol prophylactically

Question 25

What are the s/s of a mild transfusion reaction?

Answer 25

Flushing Itching Urticaria

Question 26

What should the nurse do if the patient is experiencing a mild transfusion reaction?

Answer 26

Stop blood and notify HCP

Question 27

In the case of a mild transfusion reaction, the HCP will most likely order...

Answer 27

Antihistamine - diphenhydramine Corticosteroid Restart if symptoms are transient/mild

Question 28

What are prevention methods for a mild transfusion reaction?

Answer 28

Treat prophylactically with antihistamines and corticosteroids Consider giving washed RBCs and platelets

Question 29

What are the s/s of a severe allergic reaction?

Answer 29

Anxiety Urticaria Dyspnea/wheezing Progressing to cyanosis, bronchospasm, hypotension, shock, and cardiac arrest

Question 30

What should the nurse response be to a patient experiencing anaphylaxis?

Answer 30

Initiate CPR, start o2 | Administer epi, also antihistamines, corticosteroids, b2 agonists

Question 31

Someone who experienced an anaphylactic reaction to a blood transfusion would need what prevention measures?

Answer 31

Extensively washed RBCs, and potentially autologous components

Question 32

What are the s/s of a bacterial/sepsis reaction?

Answer 32

Rapid onset of chills and high fever Vomiting and diarrhea Marked hypotension

Question 33

What should you do with any type of blood transfusion reaction first?

Answer 33

Stop the transfusion Notify the provider Return the blood

Question 34

What should you do if your patient is having a septic reaction to a blood transfusion?

Answer 34

Obtain blood culture and return blood bag to bank | Treat septicemia with abx, IVFs, and vasopressors

Question 35

What is the prevention for a septic reaction?

Answer 35

Get the blood in in 4 hours!!

Question 36

What are the s/s of a TACO reaction?

Answer 36

``` cough and dyspnea pulmonary congestion headache increased VS distended neck veins ```

Question 37

What is the nursing response to a patient experiencing a transfusion-associated circulatory overload reaction?

Answer 37

Slow or stop infusion Administer diuretics, morphine, o2 CXR stat

Question 38

What is the best way to prevent a TACO reaction?

Answer 38

Recognize who is at risk and administer slow

Question 39

What is another name for autologous transfusions?

Answer 39

Auto transfusions

Question 40

What is an autologous donation?

Answer 40

Patient donates their own blood before a planned procedure

Question 41

How long can autologous blood be kept?

Answer 41

frozen and stored for years

Question 42

If blood is not frozen, it must be used...

Answer 42

within a few weeks

Question 43

Why is autologous blood not used as much?

Answer 43

Expensive Insurance often won't pay Often the blood is wasted

Question 44

What is a blood salvage system?

Answer 44

During surgery the patient loses blood, they keep it and put it back into the patient