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Nura 115 Blood Trans
Blood Products, Transfusions, and Complications
| Question | Answer |
|---|---|
| Type of Blood Components are? (5) | Packed red blood cells Platelets Fresh-frozen plasma Albumin Cryoprecipitates |
| Packed red blood cells | Anemia and increase in erythrocyte count |
| Platelets | Evaluation of effective response determined by improvement in platelet count, normally assessed 1 hour and 18 to 24 hours after transfusion |
| Fresh-frozen plasma | Evaluation of effective response determined by improvement in coagulation studies, PTT, resolution of hypovolemia |
| Albumin | Evaluation of effective response determined by improvement in vital signs, particularly increase in blood pressure, and increase in serum albumin level |
| Cryoprecipitates | Evaluation of effective response determined by improvement in clotting factors, particularly factor VIII and fibrinogen |
| Types of Blood Donations (4) | Autologous Blood salvage Designated donor Normal Donation |
| Transfusions (4) | RBC transfusion Platelet transfusion Plasma transfusion Granulocyte (WBC) transfusion |
| Why are RBC Transfusions given? | Given to replace cells lost from trauma or surgery |
| Why are Platelet Transfusions given? | Given for low platelet counts, active bleeding, scheduled for invasive procedure |
| Why are Plasma Transfusions given? | Given to replace blood volume and clotting factors |
| Why are Granulocyte Transfusions given? | Given (rarely) to neutropenic patients |
| Acute Transfusion Reactions (7) | Febrile Hemolytic Allergic Bacterial Circulatory overload Transfusion-associated graft-versus-host disease (GVHD) TRALI |
| Hyperkalemia with transfusions | The older the blood, the greater the risk for hyperkalemia, because hemolysis causes potassium release Monitor for muscle weakness, paresthesias, abdominal cramps, diarrhea, dysrhythmias |
| Hypocalcemia with transfusions | Monitor for hyperactive reflexes, paresthesia, cramps, positive Trousseau’s and Chvostek’s signs Slow transfusion rate, notify physician if signs occur |
| Disease transmission during transfusions | Hepatitis C is commonly transmitted disease Other transmitted diseases may include hepatitis B, HIV, Epstein-Barr virus, cytomegalovirus, malaria |
| Septicemia signs during transfusions | Monitor for signs; these include rapid onset of chills and high fever, vomiting, diarrhea, hypotension, shock |
| Septicemia interventions during transfusions | Interventions include notifying physician, obtaining blood cultures and cultures from blood bag, administering oxygen, IV fluids, antibiotics, vasopressors, corticosteroids as prescribed |
| Circulatory overload signs during transfusions | Monitor for signs; these include cough, dyspnea, chest pain, wheezing, hypertension, tachycardia |
| Circulatory overload interventions during transfusions | Interventions include slowing rate of infusion, placing client upright with feet in dependent position, notifying physician, administering oxygen, diuretics, and morphine sulfate as prescribed, monitoring for dysrhythmias |
| Signs of delayed reactions | Monitor for signs of delayed reactions; delayed reactions may occur up to 1 year following transfusion, fever, mild jaundice, decreased hematocrit level |
| Interventions for Transfusion complications include | stop the transfusion start 0.9% normal saline notifying physician and blood bank monitoring client closely preparing to administer emergency medications sending urine specimen to laboratory returning all blood tubing and bags to blood bank |
| preparing to administer emergency medications (3) | antihistamines vasopressors corticosteroid |