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Blood Transfusion
Nursing, blood transfusion, transfusion therapy
| Question | Answer |
|---|---|
| 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 |