Blood Products, Transfusions, and Complications
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| Type of Blood Components are? (5) | Packed red blood cells
Platelets
Fresh-frozen plasma
Albumin
Cryoprecipitates
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| Packed red blood cells | Anemia and increase in erythrocyte count
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| Platelets | Evaluation of effective response determined by improvement in platelet count, normally assessed 1 hour and 18 to 24 hours after transfusion
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| Fresh-frozen plasma | Evaluation of effective response determined by improvement in coagulation studies, PTT, resolution of hypovolemia
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| Albumin | Evaluation of effective response determined by improvement in vital signs, particularly increase in blood pressure, and increase in serum albumin level
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| Cryoprecipitates | Evaluation of effective response determined by improvement in clotting factors, particularly factor VIII and fibrinogen
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| Types of Blood Donations (4) | Autologous
Blood salvage
Designated donor
Normal Donation
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| Transfusions (4) | RBC transfusion
Platelet transfusion
Plasma transfusion
Granulocyte (WBC) transfusion
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| Why are RBC Transfusions given? | Given to replace cells lost from trauma or surgery
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| Why are Platelet Transfusions given? | Given for low platelet counts, active bleeding, scheduled for invasive procedure
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| Why are Plasma Transfusions given? | Given to replace blood volume and clotting factors
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| Why are Granulocyte Transfusions given? | Given (rarely) to neutropenic patients
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| Acute Transfusion Reactions (7) | Febrile
Hemolytic
Allergic
Bacterial
Circulatory overload
Transfusion-associated graft-versus-host disease (GVHD)
TRALI
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| 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
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| Hypocalcemia with transfusions | Monitor for hyperactive reflexes, paresthesia, cramps, positive Trousseau’s and Chvostek’s signs
Slow transfusion rate, notify physician if signs occur
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| Disease transmission during transfusions | Hepatitis C is commonly transmitted disease
Other transmitted diseases may include hepatitis B, HIV, Epstein-Barr virus, cytomegalovirus, malaria
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| Septicemia signs during transfusions | Monitor for signs; these include rapid onset of chills and high fever, vomiting, diarrhea, hypotension, shock
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| 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
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| Circulatory overload signs during transfusions | Monitor for signs; these include cough, dyspnea, chest pain, wheezing, hypertension, tachycardia
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| 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
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| 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
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| 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
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| preparing to administer emergency medications (3) | antihistamines
vasopressors
corticosteroid
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