Podcast
Questions and Answers
A client with iron deficiency anemia is prescribed ferrous sulfate. What common adverse effect should the nurse educate the client about?
A client with iron deficiency anemia is prescribed ferrous sulfate. What common adverse effect should the nurse educate the client about?
- Increased appetite
- Light stools
- Metallic taste in the mouth
- Constipation (correct)
A child is diagnosed with iron toxicity due to accidental overdose of iron supplements. Which medication should the nurse prepare to administer?
A child is diagnosed with iron toxicity due to accidental overdose of iron supplements. Which medication should the nurse prepare to administer?
- Ferrous sulfate
- Folic acid
- Vitamin C
- Deferoxamine (correct)
A client with pernicious anemia is receiving cyanocobalamin (Vitamin B12) injections. What laboratory value should the nurse monitor as a common adverse reaction?
A client with pernicious anemia is receiving cyanocobalamin (Vitamin B12) injections. What laboratory value should the nurse monitor as a common adverse reaction?
- Sodium level
- Calcium level
- Potassium level (correct)
- Magnesium level
A client is prescribed folic acid. What should the nurse inform the client about regarding a potential common adverse reaction?
A client is prescribed folic acid. What should the nurse inform the client about regarding a potential common adverse reaction?
A client with hemophilia A is scheduled for a minor surgery. Which medication might be administered short-term to release stored factor VIII?
A client with hemophilia A is scheduled for a minor surgery. Which medication might be administered short-term to release stored factor VIII?
A nurse is teaching a client about Factor VIII and Factor IX concentrates for hemophilia. What is an important administration guideline to emphasize?
A nurse is teaching a client about Factor VIII and Factor IX concentrates for hemophilia. What is an important administration guideline to emphasize?
A client with hemophilia A is prescribed desmopressin. What adverse effect should the nurse monitor for?
A client with hemophilia A is prescribed desmopressin. What adverse effect should the nurse monitor for?
A client is receiving heparin for anticoagulation. Which laboratory value should the nurse monitor?
A client is receiving heparin for anticoagulation. Which laboratory value should the nurse monitor?
A client is prescribed warfarin. What should the nurse teach the client about their diet?
A client is prescribed warfarin. What should the nurse teach the client about their diet?
Platelet aggregation is suppressed by which class of medications?
Platelet aggregation is suppressed by which class of medications?
Which medication is commonly used in small daily doses for the prevention of cardiovascular events?
Which medication is commonly used in small daily doses for the prevention of cardiovascular events?
A client is prescribed clopidogrel. What potential adverse reaction should the nurse instruct the client to watch for?
A client is prescribed clopidogrel. What potential adverse reaction should the nurse instruct the client to watch for?
A client is receiving alteplase (tPA). What condition would contraindicate the further use of this medication?
A client is receiving alteplase (tPA). What condition would contraindicate the further use of this medication?
Why is it important to only give blood with normal saline (NS)?
Why is it important to only give blood with normal saline (NS)?
A client is receiving epoetin alfa. What potential adverse effect should the nurse monitor for?
A client is receiving epoetin alfa. What potential adverse effect should the nurse monitor for?
A client is prescribed filgrastim. What is the primary therapeutic effect of this medication?
A client is prescribed filgrastim. What is the primary therapeutic effect of this medication?
A client is receiving oprelvekin. What common adverse reaction should the nurse monitor for?
A client is receiving oprelvekin. What common adverse reaction should the nurse monitor for?
A client on coumadin has a prolonged PTT. Which blood product should the nurse prepare?
A client on coumadin has a prolonged PTT. Which blood product should the nurse prepare?
A client with anemia reports unintentional ingestion of an antacid along with his iron supplement. What impact will this have on the effectiveness of the iron?
A client with anemia reports unintentional ingestion of an antacid along with his iron supplement. What impact will this have on the effectiveness of the iron?
A patient diagnosed with iron deficiency anemia presents with the unusual symptom of craving and chewing ice. What is the term for this type of craving?
A patient diagnosed with iron deficiency anemia presents with the unusual symptom of craving and chewing ice. What is the term for this type of craving?
Which of the following instructions is MOST critical for the nurse to provide to a client prescribed ferrous sulfate to minimize staining of the teeth?
Which of the following instructions is MOST critical for the nurse to provide to a client prescribed ferrous sulfate to minimize staining of the teeth?
A client receiving cyanocobalamin asks why this vitamin must be administered via intramuscular injection. Which of the following should be a part of the nurse’s response?
A client receiving cyanocobalamin asks why this vitamin must be administered via intramuscular injection. Which of the following should be a part of the nurse’s response?
The health care provider prescribed B12 vitamin therapy and instructed the client to consume foods high in B12. Which of the following foods would the nurse encourage the client to consume?
The health care provider prescribed B12 vitamin therapy and instructed the client to consume foods high in B12. Which of the following foods would the nurse encourage the client to consume?
A pregnant client is prescribed folic acid because of the importance of the development of which of the following?
A pregnant client is prescribed folic acid because of the importance of the development of which of the following?
Administering _____ with iron supplements can increase absorption
Administering _____ with iron supplements can increase absorption
Which of the following conditions is caused by a genetic defect of coagulation factor VIII?
Which of the following conditions is caused by a genetic defect of coagulation factor VIII?
The provider is administering Desmopressin to a client, which can be given through the following routes?
The provider is administering Desmopressin to a client, which can be given through the following routes?
The client is ordered to receive DDAVP Spray, what intervention is priority?
The client is ordered to receive DDAVP Spray, what intervention is priority?
A client who is on Warfarin needs to be informed to routinely check for signs and symptoms of bleeding. Which of the following would the nurse include?
A client who is on Warfarin needs to be informed to routinely check for signs and symptoms of bleeding. Which of the following would the nurse include?
Common Drugs: Heparin (IV or SQ) & Enoxaparin/Lovenox (SQ) are what classification of drugs?
Common Drugs: Heparin (IV or SQ) & Enoxaparin/Lovenox (SQ) are what classification of drugs?
Why is it important to identify the time of onset in a patient with ischemic stroke?
Why is it important to identify the time of onset in a patient with ischemic stroke?
Which of the following are critical EMS assessments of a client showing signs and symptoms of possible stroke
Which of the following are critical EMS assessments of a client showing signs and symptoms of possible stroke
Which medication is the antidote for heparin?
Which medication is the antidote for heparin?
If a client had Anaphylactic transfusion reaction which sign is most important to monitor?
If a client had Anaphylactic transfusion reaction which sign is most important to monitor?
Fresh Frozen Plasma replaces coagulation factors. Which disease would make this blood product a priority?
Fresh Frozen Plasma replaces coagulation factors. Which disease would make this blood product a priority?
What is a priority action the nurse will take in the event a client is having a reaction to transfusion?
What is a priority action the nurse will take in the event a client is having a reaction to transfusion?
A nurse is caring for a client undergoing blood transfusion therapy and observes the client has a sudden onset of chills, headache, increased temperature and is having difficulty breathing. What type of reactions are these signs and symptoms most likely to indicate?
A nurse is caring for a client undergoing blood transfusion therapy and observes the client has a sudden onset of chills, headache, increased temperature and is having difficulty breathing. What type of reactions are these signs and symptoms most likely to indicate?
The client has laboratory finding of (Hgb 6-7). How would you classify this finding?
The client has laboratory finding of (Hgb 6-7). How would you classify this finding?
During assessment of a patient with iron deficiency anemia, which of the following physical examination findings would the nurse expect to observe?
During assessment of a patient with iron deficiency anemia, which of the following physical examination findings would the nurse expect to observe?
A nurse is teaching a client recently diagnosed with vitamin B12 deficiency about dietary modifications. Which of the following food sources would the nurse recommend the client include in their diet?
A nurse is teaching a client recently diagnosed with vitamin B12 deficiency about dietary modifications. Which of the following food sources would the nurse recommend the client include in their diet?
The nurse is caring for a patient with a history of frequent nosebleeds and easy bruising. The provider suspects a potential clotting disorder. Which of the following laboratory tests would be MOST helpful in initially evaluating this patient?
The nurse is caring for a patient with a history of frequent nosebleeds and easy bruising. The provider suspects a potential clotting disorder. Which of the following laboratory tests would be MOST helpful in initially evaluating this patient?
How do oral iron supplements impact the characteristics of a patient's stool?
How do oral iron supplements impact the characteristics of a patient's stool?
A client with iron deficiency anemia is prescribed ferrous sulfate. To enhance the absorption of iron, which of the following instructions should the nurse include?
A client with iron deficiency anemia is prescribed ferrous sulfate. To enhance the absorption of iron, which of the following instructions should the nurse include?
A client is prescribed iron dextran via IV infusion. What is a potential side effect the nurse should monitor for during the infusion?
A client is prescribed iron dextran via IV infusion. What is a potential side effect the nurse should monitor for during the infusion?
A child is admitted to the emergency department with suspected iron toxicity. Besides stomach pain, nausea, and vomiting, what is another sign of iron toxicity?
A child is admitted to the emergency department with suspected iron toxicity. Besides stomach pain, nausea, and vomiting, what is another sign of iron toxicity?
A client is being treated for iron deficiency anemia. Which instruction regarding stool changes associated with oral iron supplementation should the nurse provide?
A client is being treated for iron deficiency anemia. Which instruction regarding stool changes associated with oral iron supplementation should the nurse provide?
A client with pernicious anemia is started on cyanocobalamin injections. Post-administration, for what common adverse effect should the nurse monitor?
A client with pernicious anemia is started on cyanocobalamin injections. Post-administration, for what common adverse effect should the nurse monitor?
A client with pernicious anemia is assessed by the nurse. Which of the following assessment findings is MOST associated with vitamin B12 deficiency?
A client with pernicious anemia is assessed by the nurse. Which of the following assessment findings is MOST associated with vitamin B12 deficiency?
A client with pernicious anemia is prescribed cyanocobalamin. Why are the injections administered via the intramuscular route?
A client with pernicious anemia is prescribed cyanocobalamin. Why are the injections administered via the intramuscular route?
A nurse is providing dietary teaching for a client with vitamin B12 deficiency. The nurse should encourage the client to increase intake of which of the following foods?
A nurse is providing dietary teaching for a client with vitamin B12 deficiency. The nurse should encourage the client to increase intake of which of the following foods?
A client is prescribed folic acid due to chronic alcohol use. How does chronic alcohol use affect folate levels in the body?
A client is prescribed folic acid due to chronic alcohol use. How does chronic alcohol use affect folate levels in the body?
A client is taking folic acid supplements. What common side effect should the nurse inform the client about?
A client is taking folic acid supplements. What common side effect should the nurse inform the client about?
A nurse is providing education on folic acid to a pregnant client. Why is folic acid supplementation promoted in pregnancy?
A nurse is providing education on folic acid to a pregnant client. Why is folic acid supplementation promoted in pregnancy?
What distinguishes Hemophilia A from Hemophilia B?
What distinguishes Hemophilia A from Hemophilia B?
A client with hemophilia A is experiencing a bleeding episode. Which medication directly addresses the underlying cause of hemophilia A?
A client with hemophilia A is experiencing a bleeding episode. Which medication directly addresses the underlying cause of hemophilia A?
A client with hemophilia A is prescribed desmopressin. What physiological response does desmopressin stimulate in this client?
A client with hemophilia A is prescribed desmopressin. What physiological response does desmopressin stimulate in this client?
A client is prescribed desmopressin (DDAVP) for hemophilia A. Upon assessment, which of the following findings would warrant the most immediate intervention by the nurse?
A client is prescribed desmopressin (DDAVP) for hemophilia A. Upon assessment, which of the following findings would warrant the most immediate intervention by the nurse?
A nurse is teaching a client who will be self-administering desmopressin (DDAVP) intranasally for hemophilia A. What instruction about administration technique is most important to emphasize?
A nurse is teaching a client who will be self-administering desmopressin (DDAVP) intranasally for hemophilia A. What instruction about administration technique is most important to emphasize?
A nurse is reviewing discharge instructions with a client prescribed desmopressin (DDAVP) for mild hemophilia A. What should the nurse emphasize regarding potential adverse effects?
A nurse is reviewing discharge instructions with a client prescribed desmopressin (DDAVP) for mild hemophilia A. What should the nurse emphasize regarding potential adverse effects?
A client is receiving Factors VIII & IX, what signs and symptoms will the nurse assess for?
A client is receiving Factors VIII & IX, what signs and symptoms will the nurse assess for?
A patient with Hemophilia A is getting DDAVP via IV, what nursing considerations must the nurse take?
A patient with Hemophilia A is getting DDAVP via IV, what nursing considerations must the nurse take?
A client is prescribed Warfarin. What vital teaching point can the nurse provide?
A client is prescribed Warfarin. What vital teaching point can the nurse provide?
Choose the mechanism of action of heparin.
Choose the mechanism of action of heparin.
A client is prescribed Heparin. What is most important for the nurse to do?
A client is prescribed Heparin. What is most important for the nurse to do?
A client is reviewing contraindications of tPA (alteplase). What is a contraindication?
A client is reviewing contraindications of tPA (alteplase). What is a contraindication?
Why would a client receive alteplase (tPA)?
Why would a client receive alteplase (tPA)?
A nurse is preparing to administer epoetin alfa (Epogen) to a client with anemia. Which lab value is MOST important for the nurse to review before administering the medication?
A nurse is preparing to administer epoetin alfa (Epogen) to a client with anemia. Which lab value is MOST important for the nurse to review before administering the medication?
A client receiving filgrastim (Neupogen) is at risk for infection. What is a primary effect the nurse should monitor for?
A client receiving filgrastim (Neupogen) is at risk for infection. What is a primary effect the nurse should monitor for?
A client receiving oprelvekin (Neumega) is prescribed to help treat thrombocytopenia. What is the most important to monitor?
A client receiving oprelvekin (Neumega) is prescribed to help treat thrombocytopenia. What is the most important to monitor?
If a client had circulatory overload as a reaction to receiving red blood cells (RBCs), which sign is most important to monitor?
If a client had circulatory overload as a reaction to receiving red blood cells (RBCs), which sign is most important to monitor?
A client is receiving red blood cells and suddenly develops anxiety, impending doom, wheezing, and shock. Which reaction is this client likely experiencing and what intervention is MOST appropriate?
A client is receiving red blood cells and suddenly develops anxiety, impending doom, wheezing, and shock. Which reaction is this client likely experiencing and what intervention is MOST appropriate?
Flashcards
Iron Deficiency Anemia
Iron Deficiency Anemia
A condition in which the body lacks an adequate amount of healthy red blood cells, specifically iron.
GI side effects of oral iron
GI side effects of oral iron
Oral iron supplements include nausea, epigastric pain, diarrhea and constipation, stools may become dark green or black, stain teeth.
Iron Toxicity
Iron Toxicity
Occurs as a result of accidental or intentional overdose, leading to stomach pain, nausea & vomiting. Pediatric death related to poisoning.
B12 Nursing Interventions
B12 Nursing Interventions
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Pernicious Anemia
Pernicious Anemia
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Factors VIII & IX
Factors VIII & IX
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Desmopressin
Desmopressin
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Anticoagulants
Anticoagulants
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Drug Classification
Drug Classification
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Vitamin K Antagonists
Vitamin K Antagonists
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Antiplatelets
Antiplatelets
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Thrombolytics
Thrombolytics
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What to watch out for
What to watch out for
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Role of Epoietin Alfa
Role of Epoietin Alfa
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What is Plasma used for
What is Plasma used for
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Platelets
Platelets
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Study Notes
- The hematologic system involves drug therapies for anemia, bleeding disorders, thromboembolic conditions, supporting hematopoiesis, and using blood products.
Iron Deficiency Anemia
- Iron deficiency anemia is a condition characterized by the body's lack of an adequate amount of healthy red blood cells due to insufficient iron.
- The body lacks the necessary iron to produce red blood cells in this type of anemia.
- Causes include blood loss, insufficient iron intake, and impaired iron absorption.
Iron Deficiency Anemia Presentation
- Iron deficiency anemia can result in feeling weak or tired, shortness of breath, increased susceptibility to infection, cold hands or feet, pallor, and pica
Iron Drug Therapy
- Iron deficiency anemia is treated with ferrous sulfate (oral) or iron dextran (IM or IV).
- Iron's pharmacologic action aids in hemoglobin creation, a necessary component of RBCs, which carry oxygen.
- Common GI side effects from oral iron supplements include nausea, epigastric pain, diarrhea, and constipation; stools may become dark green or black.
- Liquid oral iron can stain teeth.
- IV iron supplements sometimes cause a metallic taste during infusion.
- Antacids may reduce oral iron absorption, while vitamin C can increase it.
Iron Toxicity
- Iron toxicity results from accidental or intentional overdose and is a leading cause of pediatric deaths related to poisoning.
- Toxicity symptoms include stomach pain, nausea, vomiting, and shock, potentially leading to multiple organ failure.
- Deferoxamine is a chelating agent used to treat iron toxicity by binding to iron and increasing its excretion.
Iron Nursing Interventions
- Take iron supplements with food.
- Monitor bowel movements.
- Use hard candy for metallic taste.
- Monitor teeth for staining.
- Administer the recommended dose only.
- Monitor for GI issues, shock, liver, and heart failure to watch out for toxicity.
Iron Patient Education
- GI side effects are frequent when taking iron supplements.
- Enteric-coated iron supplements are available, or supplements can be taken with food to reduce GI upset.
- Iron supplements can cause stools to become dark and tarry.
- Constipation is a common side effect.
- Avoid taking iron with antacids.
- Rinse mouth after oral liquid consumption.
Pernicious Anemia
- Pernicious anemia results from a vitamin B12 deficiency caused by a lack of intrinsic factor.
- Vitamin B12 deficiency is often absorption-related rather than diet-related.
- Gastrointestinal malabsorption syndromes like celiac disease or elevated gastric pH caused by H2 receptor blockers often cause it.
Cyanocobalamin
- A synthetic form of vitamin B12.
- Cyanocobalamin is often administered via IM injection.
- Oral administration is acceptable if gastric absorption is confirmed by the Schilling Test.
- Hypokalemia is a possible adverse reaction.
B12 Nursing Interventions
- Monitor potassium levels for cardiac issues and dysrhythmias
- Obtain baseline labs.
- Encourage intake of foods high in B12, such as Daisy, enriched cereal, and egg yolks.
- Consumption of alcohol affects the level of B12 absorption in the body, even in moderate amounts, and can decrease B12 absorption by about 5-6%.
Megaloblastic Anemia
- Megaloblastic anemia arises from a deficiency of vitamin B12 or folic acid (folate).
- It is necessary to identify the cause of the anemia to guide treatment.
- Megaloblastic anemia is often diet-related when caused by folic acid deficiency.
Supplemental Folic Acid
- Supplemental folic acid is needed when clients cannot obtain it through diet due to malabsorption syndromes or alcoholism.
- A common adverse reaction includes urine turning an intense yellow color.
Folic Acid Considerations
- Encourage patients to eat a diet high in folic acid.
- Monitor blood levels.
- Inform patients that their urine may become increasingly yellow.
- Chronic alcohol use impairs folate absorption, supplementation is needed.
- Babies need it for spinal cord development.
Hemophilia
- Hemophilia is an inherited bleeding disorder that causes clients to bleed longer than normal.
- Bleeding can be external or occur in joints and muscles from injuries.
- Hemophilia severity depends on the injury and the extent of bleeding.
- Hemophilia A results from a genetic defect of coagulation factor VIII.
- Hemophilia B results from a genetic defect of coagulation factor IX.
Factors VIII & IX
- Concentrates of Factor VIII & IX are used to supply these factors to clients with hemophilia A and B.
- Both factors are derived from human plasma.
- Administer as an IV bolus at regular scheduled doses.
- May cause itching, rash, and difficulties breathing
Desmopressin
- Desmopressin, also called DDVAP or Stimate, is a short-term antidiuretic hormone used for clients with hemophilia A before surgery or after traumatic injury.
- It stimulates the release of stored factor VIII.
- Can be administered IV or intranasally.
- Adverse reactions are fluid retention and hyponatremia.
DDAVP Nursing Considerations
- Adverse drug reactions include fluid retention, seizures, drowsiness, and headaches.
- Monitor input and output and sodium levels, and restrict sodium and fluids when appropriate.
- Used to treat diabetes insipidus; be aware of the other use.
- Synthetic form of vasopressin that regulates water balance and reduces frequent urination.
DDAVP Patient Education
- Obtain daily weights.
- Report weight gain and edema.
- Educate on intranasal techniques.
- Take precautions concerning HTN and heart failure.
- Interactions only matter if the drug is used for DI, not Hemophilia.
Anticoagulants
- Act by interfering with the conversion of factor Xa to thrombin, with the conversion of factor X to prothrombin, and by inhibiting vitamin K in the clotting process.
Thrombin Inhibitors
- Thrombin Inhibitors: Heparin (IV or SQ) & Enoxaparin/Lovenox (SQ).
- Monitor vital signs, lab values, bleeding, and bruising at injection sites for SQ administration.
- Avoid concomitant NSAIDS and aspirin.
- Protamine is the antidote for heparin.
Heparin versus LMWH
- UFH: administered via IV or Sub-Q, has a rapid onset and clearance, anticoagulation effects are easily monitored, ok in renal failure, can be rapidly reversed with protamine. Disadvantages include frequent monitoring and heparin-induced thrombocytopenia. Relatively contraindicated in renal failure.
- LMWH (Enoxaparin, Dalteparin): Administered via Subq, longer duration of action. Lab monitoring of anticoagulation effect is generally unnecessary. If monitoring is needed, it requires an anti-factor Xa level (which is less available than aPTT). Heparin-induced thrombocytopenia. Less reliably reversed with protamine.
Vitamin K Antagonists
- Anticoagulants like Warfarin (Coumadin) impact a patient's INR, so monitoring is vital to maintain a therapeutic range.
- Monitor vital signs for bleeding.
- Vitamin K is the antidote.
- Advise clients to watch their intake of vitamin K-rich foods.
- Contraindicated in pregnancy.
Antiplatelet Drugs
- Antiplatelet drugs suppress platelet aggregation.
Salicylates
- Common Drug: Aspirin.
- A small daily dose is effective for preventing cardiovascular and cerebrovascular events.
- Other uses include treatment of pain, fever, and inflammation.
Adenosine Diphosphate (ADP) Receptor Inhibitors
- Clopidogrel (Plavix) & ticlopidine (Ticlid).
- A common adverse reaction is gastric upset, so watch for signs of GI bleeding and advise clients to take with food.
- Thrombocytopenic Purpura (TTP) is a rare but serious reaction to clopidogrel.
Thrombolytics
- They breakdown existing clots and degrade the fibrin meshwork of a clot.
Thrombolytic Considerations
- Alteplase (Activase) also known as tPA
- Since this medication breaks down clots, watch for bleeding
- Do not give to a patient with a history of intercranial hemorrhage.
- Do not give with additional thromboembolic drugs.
- Adverse drug reactions include bleeding.
- Treatment interventions related to bleeding with the following:
- Limit venipuncture and other injections.
- Apply pressure/pressure dressings.
- Monitor VS and S/S of increased bleeding
- Monitor PTT/PT/INR, bleeding, Hemoglobin, and Hematocrit.
- The earlier the treatment, the better; monitor labs and v/s.
- Plan on long-term thrombolytic therapy with heparin, ASA, or other oral agents.
- Contraindicated if client is already bleeding.
Erythropoietic Growth Factors
- Stimulates the formation of RBCs.
- Common Drug: Epoetin alfa (Epogen or Procrit).
- Mostly used for clients with anemia preoperatively and undergoing chemotherapy and chronic renal failure.
- Watch for increased blood pressure, increased risk for cardiovascular or cerebrovascular events, and malignancy progression.
- Administer IV or SQ on a scheduled dosing or before a procedure.
- Monitor lab values.
Leukopoietic Growth Factors
- They stimulate the formation of WBCs.
- Common Drug: filgrastim (Neupogen).
- Reduces the risk of infection for clients undergoing a bone marrow transplant, those with chronic neutropenia, or those undergoing immunosuppressing chemotherapy.
- A common adverse reaction includes bone pain and fever.
- With prolonged use, splenomegaly is possible.
- Administer VI or SQ and monitor CBC weekly.
Thrombopoietic Growth Factor
- Stimulates the creation of platelets.
- Common Drugs: oprelvekin (Neumega) & eltrombopag (Promacta).
- Used to treat thrombocytopenia from myelosuppressive chemotherapy treatment.
- Fluid retention is a common adverse reaction that needs to be monitored.
- Watch for cardiac dysrhythmias, monitor vital signs, heart rate, and EKG.
- Administer SQ after chemotherapy treatment.
Red Blood Cells
- Replace blood loss/increase circulating volume (burns/dehydration/shock)
- Treat severe anemia (Hgb 6-7)
- Know patient's blood type and Rh factor
- Large risks for reaction - chills, fever, low back pain, headache, hypotension and tachycardia, and tachypnea.
- Anaphylactic reaction can occur, causing anxiety, impending doom, wheezing, and shock. Stop the transfusion, send for NS and notify a provider as Epi may be needed.
- Circulatory overload can occur, causing SOB, crackles, cough, and HTN; administer diuretics and oxygen.
Starting Infusion
- Make sure your baseline lbas, any hx or tranfusions and confirm CONSENT
- Make sure you have baseline vitals, good access and give as soon as you get it from the blood bank and infuse in 4 hours.
- Only use NS!
Blood Transfusions
- Transfusion reaction can occur!
- Assess the client closely when starting transfusion (1:1 for 15 minutes!)
- Early manifestations of a reaction include fever, itching, SOB, hives, back pain, and low blood pressure.
- Transfusion-associated circulatory overload (TACO) arises from too much fluid or circulatory overload, resulting in pulmonary edema.
- Abnormal Response: Hives/itching, mild allergic reaction
- Fever/chills: Febrile non-hemolytic reaction, acute/hemolytic reaction, bacterial contamination
- Hypotension: Acute/hemolytic reaction, bacterial contamination, anaphylactic reaction, acute lung injury
- Dyspnea: Anaphylactic Reaction, acute lung injury, volume overload.
Managing Infusion Reactions
- Stop transfusion!
- Notify provider and stay with the patient
- Assess vitals and maintain IV access with NS.
- Get labs and return blood/tubing to the blood bank.
Fresh Frozen Plasma (FFP)
- FFP replaces coagulation factos, is used for active bleeding or hemorrhaging reversal of warfarin, or burns/shock, or warfarin overdose.
Platelets
- For increasing platelet count in thrombocytopenia, anemia or bone marrow suppression
- The infusion has to be infused in 15-30 mins.
Connection Check Question
- Fresh Frozen Plasma is indicated for a client who has an elevated PTT because it replaces coagulation factors and bleeding. Platelets are would be for thrombocytopenia or ACTIVE bleeding/hemorrage
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