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Questions and Answers
If you receive an order from a doctor and the order is TPN. What should be done?
If you receive an order from a doctor and the order is TPN. What should be done?
Assess the bag, expiration and compare to MAR (VERIFY)
If a patient has a metabolic disturbance before hanging meds what should be checked before charting?
If a patient has a metabolic disturbance before hanging meds what should be checked before charting?
Labs
Lab values to check for blood transfusions?
Lab values to check for blood transfusions?
What would be some reasons a patient would refuse blood transfusions?
What would be some reasons a patient would refuse blood transfusions?
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If pt has blood transfusion but chooses not to use hospital blood what is this called?
If pt has blood transfusion but chooses not to use hospital blood what is this called?
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When hanging blood what is the tubing called?
When hanging blood what is the tubing called?
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How soon will a blood transfusion reaction take?
How soon will a blood transfusion reaction take?
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What is done before you start blood transfusion?
What is done before you start blood transfusion?
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If a nurse has 4 types of solutions: Normal solution, blood products, TPN? Which should be administered through a central line?
If a nurse has 4 types of solutions: Normal solution, blood products, TPN? Which should be administered through a central line?
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Type O, Type B, Type A: What is the universal blood type?
Type O, Type B, Type A: What is the universal blood type?
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Once blood is picked up how long do you have to administer blood?
Once blood is picked up how long do you have to administer blood?
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Most meds are good for TPN (false)
Most meds are good for TPN (false)
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What should be monitored with TPN?
What should be monitored with TPN?
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Unit of packed red blood cells is given and the next day. What labs should be looked at to see if it helped?
Unit of packed red blood cells is given and the next day. What labs should be looked at to see if it helped?
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What is the only solution that can go with blood?
What is the only solution that can go with blood?
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What is the universal receiver?
What is the universal receiver?
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How many times can a Y-tubing be used with blood transfusions?
How many times can a Y-tubing be used with blood transfusions?
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Patient that is receiving IV antibiotic with a central line with 3 lumens. In one lumen there is Normal Saline, Another has antibiotic, and a peripheral IV started in ER. The antibiotic is needed where it would be given?
Patient that is receiving IV antibiotic with a central line with 3 lumens. In one lumen there is Normal Saline, Another has antibiotic, and a peripheral IV started in ER. The antibiotic is needed where it would be given?
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Which nursing action would ensure the safety of a patient who is about the CPN?
Which nursing action would ensure the safety of a patient who is about the CPN?
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If you are receiving orders to give blood to a patient and you have a second nurse to verify. Right before you get to administer and the call light goes off what should be done with the blood product?
If you are receiving orders to give blood to a patient and you have a second nurse to verify. Right before you get to administer and the call light goes off what should be done with the blood product?
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When giving TPN and order of lipids are given. What disease process would be contraindicated for pt to receive lipids?
When giving TPN and order of lipids are given. What disease process would be contraindicated for pt to receive lipids?
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Patient started the first unit of blood and you stayed for the first 15 minutes.Call light rings and the patient's back starts to hurt. What is happening?
Patient started the first unit of blood and you stayed for the first 15 minutes.Call light rings and the patient's back starts to hurt. What is happening?
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What are some blood transfusion reaction symptoms?
What are some blood transfusion reaction symptoms?
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How often must Central Line dressing be changed?
How often must Central Line dressing be changed?
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When performing a venipuncture when should the tourniquet be released?
When performing a venipuncture when should the tourniquet be released?
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Orders to hang the unit of first red blood cells. What should be gotten from the patient?
Orders to hang the unit of first red blood cells. What should be gotten from the patient?
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Patient receiving Gauze dressing allowed to stay on the patient?
Patient receiving Gauze dressing allowed to stay on the patient?
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Supplies needed from obtaining labs from patients?
Supplies needed from obtaining labs from patients?
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What is the total hours that a TPN is allowed to hang?
What is the total hours that a TPN is allowed to hang?
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Patient is receiving a TPN and assessment is done. What is a good sign that it is helping?
Patient is receiving a TPN and assessment is done. What is a good sign that it is helping?
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If a nurse is preparing to insert a new IV into a patient. Where is the best place to try to start it?
If a nurse is preparing to insert a new IV into a patient. Where is the best place to try to start it?
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If you have a patient and you notice gauze is saturated what should be done?
If you have a patient and you notice gauze is saturated what should be done?
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The nurse is preparing herparing to use a flush to use for a patient's IV infusion site. Where should it go?
The nurse is preparing herparing to use a flush to use for a patient's IV infusion site. Where should it go?
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Patient is receiving packed red blood cells and you go in to do an assessment and palpate fine crackles. What is this?
Patient is receiving packed red blood cells and you go in to do an assessment and palpate fine crackles. What is this?
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When giving blood what all should be documented?
When giving blood what all should be documented?
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What type of additives can be found in TPN?
What type of additives can be found in TPN?
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Type of patient that are good candidates to receive TPN?
Type of patient that are good candidates to receive TPN?
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While checking a blood bath prior to infusion, the nurse notices patient blood type O and donor blood is type O. What should be done?
While checking a blood bath prior to infusion, the nurse notices patient blood type O and donor blood is type O. What should be done?
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Study Notes
Patient Care - IVs and Blood Transfusions
- TPN Orders: Verify the order with MAR (medication administration record), expiration date, and compare to the order.
- Metabolic Disturbances: Check lab values before administering medications if a patient has a metabolic problem.
- Blood Transfusion Reasons for Refusal: Jehovah's Witness is a common reason.
- Autologous Blood Transfusions: Patient's own blood is used instead of donated blood.
- Blood Transfusion Tubing: Y-tubing is used for blood transfusions.
- Blood Transfusion Reaction Time: Reactions can occur within 15 minutes; stop infusion, disconnect, and assess the patient.
- Pre-Transfusion Checks: Vital signs are obtained before a blood transfusion.
- Central Line Administration: TPN solutions should be administered through a central line.
- Universal Blood Type: Type O is the universal blood type.
- Blood Administration Time Limit: Blood must be administered within 4 hours of being removed from storage.
- TPN Monitoring: Blood sugar must be checked at least every 6 hours.
- Blood Transfusion Post-Procedure Lab Work: Hemoglobin is a key lab check after packed red blood cell transfusions.
- Compatible Fluid for Blood Transfusions: Normal saline is compatible with blood products.
- Universal Blood Recipient: Type AB is the universal receiver.
- Y-tubing Use: A Y-tubing can only be used once with blood transfusions.
- Peripheral IV Antibiotics and Central Lines: Antibiotics should be administered via a central line if intended for central use, or a peripheral IV is acceptable if used in the peripheral compartment.
- Verifying Patient Orders: Verify the prescribed product and rate with the physician's order.
- Blood Expiration Time: If a call light is triggered before administering blood and the timeframe is exceeded, return the blood to the blood bank.
- Contraindicated Lipid Use: Pancreatitis patients should not receive lipids.
- Adverse Blood Reaction Symptoms: Swelling, itching, flank pain, fever, chills, and rashes may indicate a reaction.
- Central Line Dressing Change Frequency: Central lines should be changed every 5-7 days.
- Venipuncture Tourniquet Release Timing: Release the tourniquet after the last blood sample is collected.
- Blood Product Storage Requirements: A documented order is required for the blood and for the correct type of product.
- TPN Duration: TPN infusions are typically administered for a time-frame of 24 hours.
- Assessment of Blood Transfusion/TPN Effects: Ensure that protein levels are monitored when assessing the effectiveness of TPN treatment. A good sign that the TPN is working is that protein levels are appropriate.
Other Patient Care Considerations
- Consent: Obtain consent before administering any procedure or treatment to a patient.
- Gauze Dressing Duration: Gauze dressings should stay in place for 1-2 days.
- Lab Supplies: Gloves, alcohol, cotton balls or gauze, and a tourniquet are required when obtaining patient samples.
- IV Insertion Site: Distal, non-dominant sites are the preferred insertion points.
- Gauze Saturation: Change saturated gauze dressings.
- IV Flush Location: Use central lines for flushing IV sites.
- Assessment Findings (Crackles): Crackles upon auscultation signify fluid overload.
- TPN Documentation: Document the time, patient's vital signs, volume of blood/TPN, and any additives.
- TPN Candidates: Trauma and burn patients are candidates for TPN treatment.
- Blood Typing Verification: Document any verification of blood types, including donor and blood bank types, to avoid errors.
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Description
Test your knowledge on patient care related to IVs and blood transfusions. This quiz covers essential topics such as TPN orders, metabolic disturbances, and blood transfusion protocols. Understand the critical checks and precautions necessary for safe patient care.
