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Blood Transfusion

Nursing, blood transfusion, transfusion therapy

Allergic reactions or hypersensitivity hypersensitivity to antibodies in donors blood, within 24 hrs, MILD: urticaria, itch, flushing ANAPHYLAXIS: HypoTN, dyspnea, low O2, flushing
Acute Hemolytic Reaction Incompatibility. Minutes-24 hrs, NV, Low back pain, HypoTN, increase HR, decreased UOP, hematuria
Febrile Reaction Most common, minutes - 24 hrs, Fever, Chills, N, HA, flushing, tachycardia, palpitations, seen in pts with multi transfusions
Bacterial Infection antibodies to donor platelets or leukocytes, minutes - 24 hrs, Tachycardia, HypoTN, fever, chills, shock
Circulatory Overload, TACO minutes - hours, dyspnea, crackles, increased RR, tachycardia
Nursing Considerations to Allergic reaction Premedicate w antihistamines, Stop transfusion, Restart 0.9% NaCl, Notify MD, consider benadryl, O2, corticosteroids
Nursing Considerations to Acute Hemolytic Reaction Stop blood, Supportive care: O2, benadryl, airway management
Nursing Considerations to Febrile Reaction Stop blood, Supportive care, ASA
Nursing Considerations to Bacterial infection Stop blood, obtain C & S, ABX, IV fluids, vasopressors, steroids
Nursing Considerations to Circulatory Overload monitor high risk pts: elderly, head disease, children, slow or DC transfusion
Packed RBC Use standard blood filter, companion solution 0.9% NaCl, mix cells q 20-30 minutes, give over 2-4 hrs, standard blood filter
Platelets Give quickly as possible, up to 4 units/hr, companion solution 0.9% NaCl, special set, notwettable filter
Plasma Give as quick as possible through straight line set
Albumin Use albumin set, give quickly as possible for shock, give 1 mL/min otherwise
Created by: vickyv