Blood Administration Powerpoint Piedmont Tech College Summer 2010

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Blood Administration Powerpoint Piedmont Tech College Summer 2010

  1. 1. Volume Expanders
  2. 2. Must be infused within 2 hours of thawing while clotting factors are still viable Must be infused as rapidly as possible
  3. 3. Rh factor & ABO compatibility are required for transmission of plasma products
  4. 4. Effective response is assessed by: monitoring coagulation studies PT (11-12.5 seconds) PTT (25-35 seconds) resolution of hypovolemia
  5. 5. Prepared from plasma Stored for up to 5 years Used to treat: hypovolemic shock hypoalbuminemia 25g/100 ml = 500 ml plasma
  6. 6. Used to replace erythrocytes Most commonly used with anemic patients
  7. 7. Each unit increases: Hgb 1g/1dL Hct 2-3% Hgb 12-16 g/dL Hct 35-45 %
  8. 8. Change in lab values take 4-6 hours post transfusion
  9. 9. Effective response based on: resolution of symptoms of anemia increase in erythrocyte count
  10. 10.  Confirm the transfusion has been prescribed  Verify your patient and witness consent  Confirm type and cross match  Have two nurses approve the patient and blood product ◦ Date, initial, and complete verification form ◦ Attach to the blood until transfusion is complete.  Obtain and record vitals immediately prior to administration  Be sure to assess patients reaction
  11. 11.  Monitor patient closely for 15 minutes, if no reactions occur increase flow rate  At completion record: date and time, total volume, and if any reactions occurred, and last vitals taken
  12. 12. A male patient with blood type AB, Rh factor positive needs a blood transfusion. The Transfusion Service (blood bank) sends type O, Rh factor negative blood to the unit for the nurse to infuse into this patient. The nurse knows that:
  13. 13. a. This donor blood is incompatible with the patient’s blood. b. Premedicating the patient with diphenhydramine hydrochloride (Benadryl) and acetaminophen (Tylenol) will prevent any transfusion reactions or side effects. c. This is a compatible match. d. The patient is at minimal risk receiving this product since it is the first time he has been transfused with type O, Rh negative blood.
  14. 14. Answer C. Type O, Rh negative blood has none of the major antigens and is safely administered to patients of all blood types. It is also known as the universal donor. Premedicating with these agents will not prevent a major transfusion reaction if the blood type and Rh factors of the donor blood are incompatible with the recipient’s blood.
  15. 15. Dr. Rodriguez orders 250 milliliters of packed red blood cells (RBC) for a patient. This therapy is administered for treatment of: a. Thrombocytopenia. b. Anemia. c. Leukopenia. d. Hypoalbuminemia.
  16. 16. Answer B. A red blood cell transfusion is used to correct anemia in patients in which the low red blood cell count must be rapidly corrected. RBC transfusion will not correct a low platelet count. RBC transfusion will not correct a low white blood cell count. Packed RBCs contain very little plasma and, thus, only a small amount of albumin. This amount will not correct low albumin levels.
  17. 17. A male patient needs to receive a unit of whole blood. What type of intravenous (IV) device should the nurse consider starting? a. A small catheter to decrease patient discomfort b. The type of IV device the patient has had in the past, which worked well c. A large bore catheter d. The type of device the physician prefers
  18. 18. Answer C. Large bore catheters prevent damage to blood components and are less likely to develop clotting problems than a small bore catheter. The nurse should determine the correct device without asking the patient what type has been used before or asking the physician which type he prefers and start the IV
  19. 19. Rho gam is most often used to treat____ mothers that have a ____ infant. A: RH positive, RH positive B: RH positive, RH negative C: RH negative, RH positive D: RH negative, RH negative
  20. 20. Answer C. Rho gam prevents the production of anti-RH antibodies in the mother that has a Rh positive fetus.
  21. 21. A physician tells a client that the client needs a blood transfusion and that a blood sample must be drawn first for blood typing and cross matching. After the physician leaves the client asks the nurse, “What exactly is a blood type?” The nurse responds with the following statement.
  22. 22. A. “The blood type represent an antigen found the surface of a RBC.” B. “The blood type represent an antibody found on the surface of the RBC.” C. “The blood type represents an antigen that normally circulates in the blood plasma.” D. “The blood type represent an antibody that normally circulates in the blood plasma.”
  23. 23. Answer A. The major blood type are A, B, AB, and O. The blood type indicates an antigen found on the surface of the RBC. Acute hemolytic transfusions reaction (ABO incapability) can occur if a client receives blood that is not compatible with his/her blood type. Acute Hemolytic reaction is the most serious adverse reaction to blood transfusion.
  24. 24. A hospitalized patient has received transfusions of 2 units of blood over the past few hours. A nurse enters the room to find the patient sitting up in bed, dyspneic and uncomfortable.
  25. 25. On assessment, crackles are heard in the bases of both lungs, probably indicating that the patient is experiencing a complication of transfusion. Which of the following complications is most likely the cause of the patient's symptoms?
  26. 26. A. Febrile non-hemolytic reaction. B. Allergic transfusion reaction. C. Acute hemolytic reaction. D. Fluid overload.
  27. 27. Answer: D Fluid overload occurs when then the fluid volume infused over a short period is too great for the vascular system, causing fluid leak into the lungs. Symptoms include dyspnea, rapid respirations, and discomfort as in the patient described. Febrile non- hemolytic reaction results in fever. Symptoms of allergic transfusion reaction would include flushing, itching, and a generalized rash. Acute hemolytic reaction may occur when a patient receives blood that is incompatible with his blood type. It is the most serious adverse transfusion reaction and can cause shock and death.
  28. 28. A leukemia patient has a relative who wants to donate blood for transfusion. Which of the following donor medical conditions would prevent this? A. A history of hepatitis C five years previously. B. Cholecystitis requiring cholecystectomy one year previously. C. Asymptomatic diverticulosis. D. Crohn's disease in remission.
  29. 29. Answer: A Hepatitis C is a viral infection transmitted through bodily fluids, such as blood, causing inflammation of the liver. Patients with hepatitis C may not donate blood for transfusion due to the high risk of infection in the recipient. Cholecystitis (gall bladder disease), diverticulosis, and history of Crohn's disease do not preclude blood donation.
  30. 30. A hospitalized patient is receiving packed red blood cells (PRBCs) for treatment of severe anemia. Which of the following is the most accurate statement?
  31. 31. A. Transfusion reaction is most likely immediately after the infusion is completed. B. PRBCs are best infused slowly through a 20g. IV catheter. C. PRBCs should be flushed with a 5% dextrose solution. D. A nurse should remain in the room during the first 15 minutes of infusion.
  32. 32. Answer: D Transfusion reaction is most likely during the first 15 minutes of infusion, and a nurse should be present during this period. PRBCs should be infused through a 19g or larger IV catheter to avoid slow flow, which can cause clotting. PRBCs must be flushed with 0.45% normal saline solution. Other intravenous solutions will hemolyze the cells.
  33. 33. A female patient needs a whole blood transfusion. In order for transfusion services (the blood bank) to prepare the correct product a sample of the patient’s blood must be obtained for: a. A complete blood count and differential. b. A blood type and cross-match. c. A blood culture and sensitivity. d. A blood type and antibody screen.
  34. 34. Answer B. This is needed to utilize the correct type of donor blood and to match the donor product with the patient. Incompatible matches would result in severe adverse events and possible death. The tests in options 1 and 3 are unnecessary. The test in option 4 is utilized to determine the patient’s blood type and presence of antibodies to blood antigens. It does not determine donor blood compatibility with the patient.
  35. 35. ATI Skills Module: Blood Administration www.ati.com http://www.studyguidezone.com/nclexrn_p ractice3.htm Saunders Edition 4 Comprehensive Review. Nclex- RN Examination. www.scribd.com www.nclexreviewers.com mynursinglab.com Shout out to Jay-z: Empire state of Mine

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