Blood Transfusions Overview
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Questions and Answers

What type of transfusion involves using the client’s own previously collected blood?

  • Packed RBC transfusion
  • Standard donation
  • Intraoperative blood salvage
  • Autologous transfusion (correct)

What is required for intraoperative blood salvage regarding the timing of reinfusion?

  • Must occur within 12 hours of collection
  • Must occur within 6 hours of collection (correct)
  • Must occur within 4 hours of collection
  • Must occur within 2 hours of collection

Which component is NOT included in the various blood components used for transfusion?

  • Cryoprecipitate
  • Hemoglobin solution (correct)
  • Packed RBCs
  • White blood cells

How often can a client donate blood for autologous transfusions if their hemoglobin and hematocrit are stable?

<p>Weekly until the desired amount is reached (D)</p> Signup and view all the answers

What characterizes a standard donation in transfusion types?

<p>Involves transfusion from compatible donor blood (C)</p> Signup and view all the answers

What is the primary indication for administering packed RBCs?

<p>Excessive blood loss (A)</p> Signup and view all the answers

In which scenario would fresh frozen plasma be the appropriate choice?

<p>Coagulation factor deficiencies like hemophilia (D)</p> Signup and view all the answers

What is the suitable treatment for a patient experiencing thrombocytopenia?

<p>Platelets (D)</p> Signup and view all the answers

Which transfusion component would be administered to a patient with severe burns?

<p>Albumin (B)</p> Signup and view all the answers

For a patient diagnosed with hemophilia A, which component is essential for treatment?

<p>Cryoprecipitate (A)</p> Signup and view all the answers

What is the correct procedure for platelet transfusion?

<p>Platelets must be infused immediately using a special transfusion set. (A)</p> Signup and view all the answers

What must be done before and during a plasma transfusion?

<p>Check ABO compatibility before infusion begins. (D)</p> Signup and view all the answers

What volume of fresh frozen plasma should be infused and how quickly?

<p>200 mL rapidly over 15 to 30 minutes. (C)</p> Signup and view all the answers

Which of the following statements about platelet transfusion is false?

<p>Platelets are to be administered using a long transfusion set. (C)</p> Signup and view all the answers

What is the main reason FFP needs to be infused shortly after thawing?

<p>Clotting factors remain active for a limited time. (D)</p> Signup and view all the answers

What is the recommended time interval between the administration of amphotericin B and a WBC transfusion?

<p>4 to 6 hours (A)</p> Signup and view all the answers

What volume of white blood cells should be infused over the designated period?

<p>400 mL (B)</p> Signup and view all the answers

What action should a nurse take regarding vital signs during a WBC transfusion?

<p>Take vital signs every 15 minutes (B)</p> Signup and view all the answers

What is a primary consideration when transfusing WBCs to immunocompromised clients?

<p>There is a high risk for severe reaction. (B)</p> Signup and view all the answers

According to agency policy, what may be required during a WBC transfusion?

<p>The presence of the provider may be required. (B)</p> Signup and view all the answers

What is the maximum gauge size needle recommended for older adult clients receiving blood transfusions?

<p>19-gauge (C)</p> Signup and view all the answers

Within what time frame should a blood transfusion be initiated after obtaining the blood product?

<p>30 min (B)</p> Signup and view all the answers

During a blood transfusion, how often should vital signs be assessed for older adult clients?

<p>Every 15 min (B)</p> Signup and view all the answers

What should be done if signs of a transfusion reaction occur?

<p>Notify the provider immediately. (B)</p> Signup and view all the answers

What is an important action to take regarding IV fluids during blood transfusion for older adult clients?

<p>Withhold administration of other IV fluids. (A)</p> Signup and view all the answers

What is the recommended infusion time for a unit of packed RBCs?

<p>2 to 4 hours (B)</p> Signup and view all the answers

What must be done to ensure compatibility when administering packed red blood cells?

<p>Follow blood transfusion protocols strictly. (D)</p> Signup and view all the answers

Which blood type lacks antibodies against A and B antigens?

<p>Type AB (C)</p> Signup and view all the answers

Why must Rh-negative patients be cautious when receiving transfusions?

<p>They develop antibodies only if sensitized. (D)</p> Signup and view all the answers

What is one of the nursing actions recommended before starting a transfusion?

<p>Assess and document baseline vital signs. (A)</p> Signup and view all the answers

What should the nurse verify to prevent mismatched blood transfusions?

<p>The blood product against the client's name and ID. (C)</p> Signup and view all the answers

When should the nurse remain with the client during a blood transfusion?

<p>For the first 15 to 30 minutes. (B)</p> Signup and view all the answers

What gauge needle is standard for administering blood products?

<p>18-gauge needle (C)</p> Signup and view all the answers

What is a potential serious complication of an acute hemolytic transfusion reaction?

<p>Disseminated intravascular coagulation (DIC) (C)</p> Signup and view all the answers

What symptom is NOT commonly associated with an acute hemolytic transfusion reaction?

<p>Headache (B)</p> Signup and view all the answers

What is the first nursing action to take if an acute hemolytic transfusion reaction is suspected?

<p>Stop the transfusion (D)</p> Signup and view all the answers

Which of the following findings can indicate an acute hemolytic transfusion reaction?

<p>Tachycardia (A)</p> Signup and view all the answers

Which preventive action helps ensure compatibility during blood transfusions?

<p>Double-check the blood type and Rh factor (B)</p> Signup and view all the answers

What symptoms are commonly associated with a febrile transfusion reaction?

<p>Chills and hypotension (D)</p> Signup and view all the answers

What is the most appropriate nursing action to prevent a febrile transfusion reaction?

<p>Use a WBC filter during transfusion (A)</p> Signup and view all the answers

Which vital sign change is characteristic of a febrile transfusion reaction?

<p>Increase of 1° C or greater from pretransfusion temperature (A)</p> Signup and view all the answers

What should be administered after stopping the transfusion in the case of a febrile transfusion reaction?

<p>Antipyretics (A)</p> Signup and view all the answers

In which situation is a febrile transfusion reaction most likely to occur?

<p>After multiple transfusions have been given (C)</p> Signup and view all the answers

What is a common symptom associated with a mild allergic transfusion reaction?

<p>Flushing (C)</p> Signup and view all the answers

What should a nurse do first if a patient exhibits anaphylactic symptoms during a blood transfusion?

<p>Stop the transfusion (C)</p> Signup and view all the answers

Which of the following actions is appropriate for managing a mild allergic transfusion reaction?

<p>Administer an antihistamine (B)</p> Signup and view all the answers

In the case of a severe allergic reaction, what medication should be administered?

<p>Corticosteroids (B)</p> Signup and view all the answers

What is a potential severe complication of an anaphylactic transfusion reaction?

<p>Shock (B)</p> Signup and view all the answers

What is the first nursing action to take if a bacterial transfusion reaction is suspected?

<p>Stop the transfusion (B)</p> Signup and view all the answers

Which of the following symptoms is NOT associated with a bacterial transfusion reaction?

<p>Nausea and vomiting (B)</p> Signup and view all the answers

What should be done after stopping a transfusion suspected of causing a bacterial reaction?

<p>Administer antibiotics (B), Send a blood culture specimen (C)</p> Signup and view all the answers

What is a common finding associated with bacterial transfusion reactions?

<p>Shock (D)</p> Signup and view all the answers

Which action is NOT appropriate for managing a bacterial transfusion reaction?

<p>Administer antihistamines (B)</p> Signup and view all the answers

What conditions might increase the risk of circulatory overload during a blood transfusion?

<p>Older age and preexisting increased circulatory volume (B)</p> Signup and view all the answers

Which of the following findings is NOT associated with circulatory overload during a transfusion?

<p>Decreased blood pressure (B)</p> Signup and view all the answers

What is the immediate nursing action to take when signs of circulatory overload appear during a transfusion?

<p>Slow or stop the transfusion (B)</p> Signup and view all the answers

What should the nurse do to manage a client experiencing circulatory overload?

<p>Administer oxygen, diuretics, and morphine as prescribed (B)</p> Signup and view all the answers

Which of the following positions is appropriate for a client experiencing symptoms of circulatory overload?

<p>Upright with feet lower than the heart (B)</p> Signup and view all the answers

Flashcards

Blood transfusion types

Blood transfusions can involve whole blood or its components, like packed RBCs, WBCs, plasma, clotting factors, and platelets, depending on the need.

Autologous transfusion

A blood donation method where a patient donates their own blood in anticipation of a future transfusion, usually before surgery.

Intraoperative blood salvage

Saving blood lost during surgery by filtering it and storing it for transfusion during or after the procedure.

Standard donation

Blood transfusion from a compatible donor.

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Maximum allowable blood donation frequency

Clients can donate blood up to 6 weeks before scheduled surgery. Donations can happen weekly, if hemoglobin and hematocrit are stable, but only if the goal is met.

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Excessive blood loss

A condition where a patient has lost a significant amount of blood, requiring immediate medical attention.

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Anemia

A condition where the blood lacks enough healthy red blood cells, leading to insufficient oxygen delivery to the body.

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Kidney failure

When the kidneys are unable to filter waste products from the blood, requiring treatment.

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Coagulation factor deficiencies

Medical conditions where the body lacks sufficient clotting factors, leading to prolonged bleeding.

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Thrombocytopenia/platelet dysfunction

A condition where there are not enough platelets in the blood or platelets function abnormally, increasing the risk of bleeding.

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Platelet transfusion

A blood transfusion specifically focused on increasing platelet count, used to prevent or stop bleeding in individuals with low platelet levels.

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Platelet transfusion compatibility

Platelets do not need to be matched to the client's blood type.

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Platelet infusion time

Infusion time for platelets typically takes 15 to 30 minutes using a special transfusion set.

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Plasma transfusion

A blood transfusion using plasma, the liquid portion of blood, containing clotting factors and other proteins.

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Plasma transfusion compatibility

Plasma needs to be ABO compatible with the client's blood type.

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WBC Transfusion Reaction Risk

Immunocompromised patients are at higher risk for severe reactions when receiving white blood cell (WBC) transfusions.

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WBC Transfusion Timing with Amphotericin B

Amphotericin B, a specific type of antibiotic, can destroy WBCs. Therefore, WBC transfusion should be scheduled at least 4-6 hours after amphotericin B administration.

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WBC Transfusion Infusion Time

White blood cell (WBC) transfusions are typically infused over 45 to 60 minutes.

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WBC Transfusion Volume

WBC transfusions are usually suspended in 400 mL of plasma.

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WBC Transfusion Vital Signs

Vital signs are monitored every 15 minutes during WBC transfusion.

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Blood transfusion complications

Blood transfusions can cause reactions, such as fever, chills, and even life-threatening conditions. The most critical reactions often happen within the first 15 minutes.

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Transfusion time for older adults

Older adults often receive blood transfusions over a longer period (2 to 4 hours) compared to younger patients.

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Fluid overload risk

Older adults, especially those with heart or kidney issues, are more susceptible to fluid overload during blood transfusions.

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Vital signs monitoring

During blood transfusions, it's crucial to monitor vital signs, especially in older adults, as fluctuations in pulse, blood pressure, or breathing can indicate complications.

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Y-tubing with filter

A special tubing setup with a filter is used to transfuse blood, ensuring a safe delivery and removing any potential contaminants.

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Washed RBCs

Red blood cells that have been processed to remove most white blood cells (WBCs). This is done to reduce the risk of transfusion reactions in patients with a history of reactions or those who have had a hematopoietic stem cell transplant.

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Type and Crossmatch

A laboratory test to check for compatibility between a donor's blood and a recipient's blood. It involves identifying blood type and ensuring that the recipient's antibodies will not react with the donor's red blood cells.

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Rh Factor Compatibility

Another important consideration for blood transfusions. Rh-negative individuals lack the Rh antigen and can develop antibodies if exposed to Rh-positive blood. A subsequent transfusion with Rh-positive blood will cause a reaction.

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Blood Transfusion Reaction Signs

Most severe reactions occur within the first 15-30 minutes of a transfusion. Monitor the client closely during this time for signs of a reaction, such as fever, chills, shortness of breath, and rash.

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Blood Product Verification

Two registered nurses (or an RN and a licensed practical nurse) must verify the correct blood product and patient by matching the identification numbers on the blood product and the patient's wristband.

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Blood Administration Set

The tubing used to administer blood products. Prime the set with 0.9% sodium chloride (normal saline) only. Never use other solutions.

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Inspecting Blood Products

Before transfusion, visually inspect the blood product for any abnormalities such as discoloration, excessive bubbles, or cloudiness. This helps ensure safety.

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Large-Bore IV Access

Use an 18- or 20-gauge needle to administer blood products. Larger needles allow for faster infusion.

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Acute hemolytic transfusion reaction

A life-threatening complication that happens when incompatible blood types are transfused. The body's immune system attacks the transfused red blood cells, leading to widespread damage.

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Signs of acute hemolytic transfusion reaction

Symptoms include chills, fever, low back pain, rapid heart rate, low blood pressure, chest pain, shortness of breath, nausea, anxiety, and dark urine.

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Immediate action for acute hemolytic transfusion reaction

Stop the transfusion immediately, remove the blood tubing, initiate normal saline infusion, and monitor vital signs diligently.

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What causes acute hemolytic transfusion reaction?

It occurs when blood products are incompatible with the recipient's blood type (ABO) or Rh factor.

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Impact of acute hemolytic transfusion reaction

This reaction can lead to disseminated intravascular coagulation (DIC) and circulatory collapse, threatening the patient's life.

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Febrile Transfusion Reaction

A reaction occurring within 2 hours of transfusion, caused by antibodies against white blood cells, often seen in patients with multiple transfusions.

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Febrile Transfusion Reaction Findings

Characterized by chills, a temperature increase of 1°C or more, hypotension, and tachycardia.

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Preventing Febrile Transfusion Reactions

Use a WBC filter during transfusion to remove white blood cells, minimizing the risk of antibody reaction.

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Managing Febrile Transfusion Reactions

Stop the transfusion immediately, administer antipyretics, and initiate a saline infusion using fresh tubing.

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Why does a saline infusion help?

It helps restore fluid volume and blood pressure, counteracting the hypotension caused by the reaction.

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Allergic Transfusion Reaction

A sensitivity reaction to a component of the transfused blood products, usually mild with itching, urticaria, and flushing. Can escalate to anaphylaxis with bronchospasm, laryngeal edema, hypotension, and shock.

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Mild Allergic Transfusion Reaction

Symptoms include itching, urticaria, and flushing. Stop the transfusion, administer 0.9% sodium chloride, and give an antihistamine such as diphenhydramine.

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Anaphylactic Transfusion Reaction

A life-threatening reaction characterized by bronchospasm, laryngeal edema, hypotension, and shock. Stop the transfusion, administer epinephrine, corticosteroids, vasopressors, oxygen, and CPR if necessary.

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Why use 0.9% sodium chloride?

Used for both mild and anaphylactic reactions to restore fluid volume and blood pressure, particularly during transfusion cessation.

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What to do first?

The most important step in both mild and anaphylactic transfusion reactions is to immediately stop the transfusion.

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Bacterial Transfusion Reaction

A potentially life-threatening complication occurring during or within hours after a transfusion, caused by contaminated blood products resulting in symptoms like wheezing, dyspnea, chest tightness, cyanosis, hypotension, and shock.

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What are the nursing actions for a Bacterial Transfusion Reaction?

Immediately stop the transfusion, administer antibiotics, and initiate an IV infusion of 0.9% sodium chloride using new tubing. Send a blood culture specimen to the lab for analysis.

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What does cyanosis indicate?

Cyanosis is a bluish discoloration of the skin and mucous membranes due to a lack of oxygen in the blood, a symptom of a severe bacterial transfusion reaction.

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Why is 0.9% sodium chloride used?

0.9% sodium chloride, also known as normal saline, is used to restore fluid volume and blood pressure, especially after stopping a blood transfusion due to a reaction.

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Why send a blood culture?

A blood culture is sent to the lab to identify the specific bacteria causing the infection and determine appropriate treatment.

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Circulatory overload

A condition that occurs when blood is transfused too quickly, overwhelming the circulatory system. It can cause symptoms like shortness of breath, coughing, and fluid build-up in the lungs (pulmonary edema).

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Risk factors for circulatory overload

Older adults and patients with preexisting conditions that increase circulatory volume (like heart failure) are more susceptible to circulatory overload during blood transfusions.

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Signs of circulatory overload

Symptoms include crackles (rales) in the lungs, shortness of breath (dyspnea), coughing, anxiety, bulging neck veins (jugular vein distention), and rapid heartbeat (tachycardia).

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Nursing interventions for circulatory overload

Slow or stop the transfusion, elevate the patient's legs, administer oxygen, and give prescribed medications like diuretics or morphine.

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Why are diuretics helpful?

Diuretics help to remove excess fluid from the body, reducing overload in the circulatory system.

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Study Notes

Blood Transfusions

  • Clients receive blood transfusions to replace lost blood or treat blood disorders.
  • Blood components include packed red blood cells, washed red blood cells, white blood cells, fresh frozen plasma, albumin, clotting factors, cryoprecipitate, and platelets.
  • Standard donation involves transfusion from a compatible donor.
  • Autologous transfusions are when a client's own blood is collected for future use (like for elective surgery).
  • Clients can donate up to 6 weeks before surgery and, if hemoglobin and hematocrit are stable, can donate weekly until the needed amount is collected.
  • Intraoperative blood salvage involves saving blood lost during surgery to reuse it during or after the procedure.
  • Saved blood must be reinfused within 6 hours of collection.

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Description

This quiz covers essential information related to blood transfusions, including types of blood components and donation processes. It also explains standard and autologous transfusions, as well as intraoperative blood salvage techniques. Test your knowledge on how clients receive blood and the protocols involved in transfusion therapies.

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