Blood Transfusion Therapy and Nursing Care

Flashcards covering blood transfusion types, nursing responsibilities, blood bank roles, and various acute and delayed transfusion reactions based on the provided clinical text.

Whole-blood transfusions

Blood products not approved by the U.S. Food and Drug Administration for civilian use due to the inability to complete infectious disease testing before use.

Specialist in Blood Banking Technology (SBB)

A certified blood bank role capable of performing all operations from routine testing to leadership, including supervising staff and research.

Donor Phlebotomy Technician (DPT)

A certified role within the blood bank that specializes specifically in the collection of blood from donors.

Packed Red Blood Cells (PRBCs)

A concentrated source of RBCs supplied in 250-mL bags, primarily used to replace cells lost from trauma, surgery, or impaired maturation.

Platelet Transfusion Threshold

The point at which platelets are typically administered, defined as counts falling below $10,000/mm^3$ ($10 imes 10^9/L$).

Platelet Infusion Administration

Must be infused immediately over a 15- to 30-minute period using a special transfusion set with a smaller filter and shorter tubing to prevent adherence.

Fresh-frozen plasma (FFP)

Plasma frozen immediately after donation to preserve clotting factors; it must be infused immediately after thawing, generally over a 30- to 60-minute period.

Granulocyte (White Blood Cell) Transfusions

WBCs suspended in 400 mL of plasma infused slowly over 45 to 60 minutes for neutropenic patients with an active infection.

Amphotericin B and WBC Transfusions

Drug administration that must be separated from WBC transfusions by 4 to 6 hours to prevent cell hemolysis and masking of transfusion reactions.

Massive Transfusion Protocol (MTP)

A protocol for restoration of volume and oxygen-carrying capacity during hemorrhage, often using a 1:1:1 ratio of packed RBCs, plasma, and platelets.

Type and Crossmatch

The procedure of testing the donor's blood and the recipient's blood for compatibility.

Blood Administration IV Solution

Normal saline ($0.9\% \text{ NaCl}$); other solutions like Ringer's lactate or dextrose are contraindicated as they cause clotting or hemolysis.

Dual Professional Verification

The requirement that two registered nurses check the blood component, patient identification, blood type, Rh factor, and expiration date before administration.

Initial Transfusion Monitoring

The nurse must remain with the patient for the first 15 to 30 minutes, as severe reactions usually occur within the first 50 mL of infusion.

Hyperkalemia in Transfusions

An electrolyte imbalance caused by the release of potassium from damaged cells, most likely occurring in blood that has been frozen or is several weeks old.

Transfusion in Older Adults

Requires a needle no larger than 20 gauge, blood preferably less than 1 week old, and vital signs taken every 15 minutes to monitor for fluid overload.

Acute Hemolytic Transfusion Reaction

A reaction caused by ABO or Rh incompatibility during the first 15 minutes, characterized by chills, fever, low back pain, tachycardia, and shock.

Febrile Nonhemolytic Reaction

Occurs in patients with anti-WBC antibodies; symptoms include rigors, headache, tachycardia, and a temperature increase of more than $1^{\circ}C$.

Transfusion-Associated Circulatory Overload (TACO)

A pulmonary reaction from rapid infusion characterized by a bounding pulse, hypertension, neck vein distention, and a decrease in oxygen saturation to below $90\%$.

Transfusion-Related Acute Lung Injury (TRALI)

A life-threatening reaction occurring when donor blood contains antibodies against recipient neutrophil antigens, causing acute hypoxemic respiratory distress.

Transfusion-Associated Graft-Versus-Host Disease (TA-GVHD)

A rare but serious reaction where donor T-lymphocytes attack host tissues, typically occurring 1 to 2 weeks after transfusion.

Preoperative Autologous Blood Donation

A type of autologous transfusion where a patient donates their own whole blood weekly; fresh packed RBCs can be stored for 40 days or frozen for 10 years.

Acute Normovolemia Hemodilution

The withdrawal of a patient's whole blood immediately after anesthesia induction to be stored for up to 6 hours and reinfused after surgery.

Intraoperative Autologous Transfusion

The recovery and reinfusion of a patient's own blood from an operative field or bleeding wound, which must be reinfused within 6 hours.