Blood and Blood Product Transfusion(exam 2 midterm)

Blood components

rbc(packed)

washed rbc(WBC- poor rbc)

wbc

fresh frozen plasma

albumin

clotting factors

plt's

Transfusion Types

Standard donation - transfusion from a compatible donor

Autologous - use own blood before surgery; up to 6 weeks prior

Intraprocedural - blood loss during surgery reused( w/in 6h hours)

Indications for Transfusion

blood loss

kidney failure

low albumin

anemia

Plt tranfusions

doesn't need to match blood type

given over 15-30 min and done immediately

Preprocedure for blood transfusion

type and match for rbc

blood type based on presence of antigens

blood type compatibility

O- is universal donor

AB+ is universal recipient

plp who are Rh negative are born w/out antigen unless sensitized to it

Nursing care for transfusions

baseline vitals

stay with client 15-30 min to monitor reactions

2 nursing check offs

initiate transfusing w/in 30 min of getting blood

Complications of Blood Transfusions

Acute Hemolytic Transfusion Reaction

Fever

Allergic reaction

Bacterial reaction

Transfusion-associated circulatory overload(TACO)

Transfusion related acute lung injury(TRALI)

Acute hemolytic transfusion reaction

onset: immediate; during

-results b/c blood is incompatible w/client blood type or Rh factor

- can occur with as little as 10mL

findings: fever/chills/low-back pain/tachycardia/sense of doom

Nursing actions for acute hemolytic transfusion reaction

stop infusion

remove blood tubing

initiate 0.9 sodium chloride

monitor vitals and fluids

send blood to lab

Transfusion complication: FEVER

onset: 2hr

-results b/c client develops wbc antibodies

findings: chills/ Increase in 1 F/ hypotension/ tachycardia

Nursing actions with FEVER complication

use wbc filter to prevent reaction

use antipyretics

initiate 0.9

Transfusion complication: Allergic Reaction

onset: during or after 24 hrs

-results b/c client reacts to components in blood

findings: urticaria/flushing/itching

severe findings: anaphylaxis/bronchospasms/shock)

Nursing actions for allergic reaction complication (mild)

stop transfusion

initiate 0.9

antihistamines

if provider reorders administer product slowly

Nursing actions for allergic reaction complication (severe)

stop tranfusion

admin epi/o2/ or CPR

remove blood

initiate 0.9

Transfusion complication: Bacterial Reaction

onset: during or a couple hours after

- results b/c contaminated blood

findings: wheezing/dyspnea/cyanosis/chest tightness

Nursing actions for bacterial reaction complication

stop transfusion

antibiotic IV

0.9

send blood culture

Transfusion Associated Circulatory Overload (TACO)

onset: anytime

-results b/c rapid infusion or b/c preexisting conditions

findings: crackles/dyspnea/JVD/peripheral edema

TX: diuretics

Nursing Actions for TACO

stop or slow the transfusion

position feet lower than heart

admin O2/diuretics/morphine

Transfusion Related Acute Lung Injury (TRALI)

onset: w/in 6 hours

-results b/c donors blood antibodies react w/patients cells

fluid then leaks into lungs b/c inflammation

findings: hypotension/no signs of volume overload

TX: supportive care(ARDS)