Pediatric Nursing Blood Transfusion Quiz

Introduction to Blood Transfusion

• Blood transfusion is a common medical procedure in which donated blood or blood components are given to a child through an intravenous line.
• The goal of blood transfusion is to replace blood and blood components that may be too low due to an injury, during surgery, or certain medical conditions that affect blood or its components.

Definition and Purpose

• Blood transfusion is done to replace the liquid or cells found in blood, such as red blood cells, plasma, or platelets.
• It is also done to treat certain medical conditions that affect blood or its components.

Types of Blood Transfusion

• Blood components that can be transfused include:
  • Platelets (Plt) for active hemorrhage, thrombocytopenia with bleeding, or as indicated by clinical status.
  • Factor VIII (plasma derived or recombinant) for hemophilia A, acquired factor VIII deficiency.
  • Factor IX (plasma derived or recombinant) for hemophilia B.

Indications for Blood Transfusion

• Anemia:
  • Iron deficiency anemia
  • Hemolytic anemia (e.g., thalassemia, sickle cell anemia, G6PD deficiency, spherocytosis)
  • Vitamin deficiency anemia
  • Aplastic anemia
• Child with renal or liver disease
• Bleeding disorder:
  • Hemophilia A, B, C
  • Thrombocytopenia (e.g., ITP)
• Cancer:
  • Leukemia
  • Lymphoma

Risks and Reactions of Blood Transfusion

• Allergic reaction: recipient reaction to allergens in donor's blood
  • Symptoms: rash, itching, flushing, wheezing, rapid breathing, coughing, dyspnea, pain, hypertension, severe headache, chills, fever, pain at needle site and along venous tract, red or black urine, flank pain, signs of shock or renal failure
  • Treatment: stop transfusion, administer antihistamine or epinephrine, provide oxygen therapy, diuretic, and supportive care
• Circulatory overload: too much blood administered or rapid transfusion
  • Symptoms: hypertension, severe headache, chills, fever, pain at needle site and along venous tract, red or black urine, flank pain, signs of shock or renal failure
  • Treatment: stop transfusion, assess vital signs, oxygen therapy, diuretic, and supportive care
• Air emboli: may occur when blood is transfused under pressure
  • Symptoms: dyspnea, chest pain, apprehension
  • Treatment: clear tubing of air, disconnect and allow blood to flow until air has escaped
• Hypothermia: administration of cold blood
  • Symptoms: chills, low temperature, irregular heart rate
  • Treatment: allow blood to warm at room temperature

Nursing Intervention

• Pre-procedure:
  • Identify donor and recipient blood groups before transfusion
  • Transfuse blood slowly for the first 20 minutes and/or initial 20% of blood volume
• During procedure:
  • Remain with the child
  • Stop transfusion immediately if signs of reaction or overload occur
• Post-procedure:
  • Assess vital signs
  • Monitor for signs of reaction or overload
  • Provide oxygen therapy and diuretic as needed