Blood

Question 1

Blood transfusions?

Answer 1

Replaces RBCs, WBCs, platelets or blood proteins
-may be d/t hemorrhage, disease, improve body’s O2 carrying capacity, improving clotting time

Can introduce whole blood or blood components into venous circulation
Ex. Plasma, albumin

Question 2

Purpose of blood transfusions?

Answer 2

Increase circulating volume
Increase RBCs to maintain/return hemoglobin level
(O2 carrying capacity)
To provide selected cellular component replacements

Question 3

Equipment for blood transfusion?

Answer 3

Y tubing
18-20 gauge

Use appropriate assigned equipment for blood products

Equipment should be changed after 4 hours of hanging or after 4 units of blood or before administering a different product

Question 4

Can medications be added to blood?

Answer 4

No medications cannot be added to blood or blood products

Question 5

LPN responsibilities for blood transfusions?

Answer 5

Assist RN with verification of patient and blood/blood products
Documentation of verification
Assessment of patient for transfusion reaction
Notifying rn immediately if S&S are noted
Assist with vital signs after the first 15 min of infusion starting (RN does first set)

Question 6

Acute vs delayed transfusion reactions?

Answer 6

Acute: symptoms appear within minutes and up to 24hrs after transfusion

Delayed: symptoms appear 24hrs and months after transfusion

Question 7

Management of transfusion reactions?

Answer 7

Stop transfusion
-disconnect from IV site
-keep vein open with NS and new IV set
Assess patient vitals and symptoms and stabilize pt
-remain with pt
Reconfirm identifiers
-call lab immediately if error has occurred
Notify physician
Follow instructions for management
Initiate transfusion reaction investigation

Question 8

Transfusion adverse reactions?

Answer 8

Hemolytic reaction 
Febrile non-hemolytic reaction
Allergic reaction 
Severe allergic reaction 
Circulatory overload

Question 9

Hemolytic reaction?

Answer 9

ABO incompatibility

-chills, fever, dark urine, vomiting, dyspnea, chest pain, hypotension

Question 10

Febrile non-hemolytic reaction?

Answer 10

Sensitivity to cytokines in the plasma of the transfused blood component

-fever, chills, n/v, hypotension

Question 11

Allergic reaction?

Answer 11

Sensitivity to infused plasma protein
Antibody-antigen reaction

Flushing, hypotension, dyspnea/cough, edema, shock

Question 12

Circulatory overload?

Answer 12

Impaired cardiac function or blood administered faster than can accommodate

-dyspnea, cyanosis, tachycardia, HTN

Question 13

Whole blood?

Answer 13

Hemorrhage

Replaces blood volume and all blood products

Question 14

PRBCs?

Answer 14

Used to increase oxygen carrying capacity

-anemia, surgery, bleeding disorders

Question 15

Autologous donation?

Answer 15

When client donates own blood to be given to themselves

-surgery

Question 15

Fresh frozen plasma?

Answer 15

Expands blood volume and provides clotting factors

Question 16

Albumin and plasma protein fraction?

Answer 16

Blood volume expander

Provides plasma proteins

Question 17

Blood type O?

Answer 17

Universal donor and can only receive O

Question 18

Rh factor?

Answer 18

Blood that contains Rh factor is positive
Blood without Rh factor is negative and does not contain Rh antibodies

Exposure to Rh positive causes hemolytic reactions

Question 19

How to avoid transfusion reactions?

Answer 19

Blood typing (determining ABO group) and cross matching (identifies possible interactions)

Question 20

What needs to be verified on blood and pt?

Answer 20

ABO and Rh compatibility of the product and recipient
Identifiers on product match those on intended recipient
Product identifiers match accompanying transfusion tag

Question 21

Nursing interventions for circulatory overload?

Answer 21

Stop transfusion
Place client in upright position
Notify appropriate team member
Administer diuretics and oxygen as ordered