Nursing Care: Blood Transfusions, Palliative & End-of-Life Care, and Oncology

Practice flashcards covering blood transfusion protocols, adverse reactions, nursing responsibilities, palliative and hospice care definitions, teletherapy vs. brachytherapy, and oncology review questions.

What are the common clinical indications for administering a blood transfusion?

Anemia, severe blood loss, coagulation disorders (such as DIC and thrombocytopenia), burns, and shock.

Why do patients experiencing a blood transfusion reaction develop fever and chills?

Fever and chills occur as the body's earliest immune response when an attacking antigen triggers the destruction or breakdown of red blood cells (hemolysis).

What is the nurse's immediate priority action upon suspecting a blood transfusion reaction?

Stop the transfusion immediately before initiating any other intervention or contacting the healthcare provider.

Why must the nurse keep the vein open (KVO) with IV fluids following a blood transfusion reaction?

To maintain patency of the IV access port so emergency medications or IV drips can be administered quickly without the vein clotting or blocking.

Which equipment must be retained and returned to the blood bank following a transfusion reaction?

The blood bag, IV filter, and IV tubing must all be saved and returned to the blood bank for investigation and error analysis.

What is the priority nursing action required before initiating a unit of packed red blood cells (PRBCs)?

Verifying the client's identity and blood product information with another licensed nurse using the two-nurse verification technique.

Within what time frame must a blood transfusion be started after receiving the unit from the blood bank?

Within $30\text{ minutes}$ (specifically within $29\text{ minutes}$). If the $30\text{th minute}$ is reached, the blood cannot be used and must be returned to the blood bank.

What is the maximum allowable duration for infusing a unit of blood?

Less than $4\text{ hours}$.

Under what condition can monitoring of a blood transfusion be delegated from an RN to an LPN/LVN?

After the initial $15\text{ minutes}$ have elapsed and the patient remains stable without signs of reaction, though the RN must still follow up and complete final documentation.

How does palliative care differ from hospice care regarding disease treatment?

Palliative care continues active curative treatments (such as chemotherapy, dialysis, or surgery) alongside symptom management and comfort care, regardless of disease stage.

What are the primary eligibility criteria and prognosis required for hospice care?

A terminal diagnosis certified by a physician with an expected prognosis of $6\text{ months}$ or less to live, where curative treatments have been stopped.

What is the key timing difference between hospice care and end-of-life care?

Hospice care is typically initiated for patients with $6\text{ months}$ or less to live, whereas end-of-life care focuses specifically on the final days or hours of life.

Is a patient receiving external beam radiation therapy (teletherapy) considered radioactive?

No. The patient is not a source of radiation and poses no radiation exposure risk to other individuals.

What skin care instructions should the nurse provide to a patient receiving teletherapy?

Gently wash the treated area with warm water and mild soap, pat dry without rubbing, do not remove the ink 'X' markings, avoid constrictive clothing, and apply sunscreen with a minimum of $30\text{ SPF}$ if exposed to the sun.

What safety precautions must be implemented for a patient undergoing brachytherapy (internal radiation)?

The patient is radioactive and must be placed in temporary isolation, avoiding close contact with pregnant women and children; nurses must wear PPE, maintain distance, minimize bedside time, and utilize lead shielding.

What hydration instruction is essential for the parents of a child with sickle cell disease?

Provide extra fluids when the child plays outside, especially during hot weather, to prevent dehydration from triggering a sickle cell crisis.

What injection technique is required when caring for a client with severe thrombocytopenia (platelet count of $18{,}000$)?

Use a small-gauge needle for injections and apply direct pressure to the site for $5\text{ to }10\text{ minutes}$ to avoid trauma and excessive bleeding.

Why does a temperature of $100.5^\circ\text{F}$ in a client with acute myeloid leukemia and an absolute neutrophil count (ANC) of $450$ require immediate action?

An ANC of $450$ indicates severe neutropenia, leaving the patient at high risk for life-threatening infection where a low-grade fever signals compromised health requiring immediate reporting.

Why is increasing dietary intake of red meat and spinach ineffective for managing aplastic anemia?

Iron-rich foods only treat iron deficiency anemia, whereas aplastic anemia is caused by bone marrow damage leading to pancytopenia (deficiency of RBCs, WBCs, and platelets).