Blood transfusions and Transfusion Reactions.docx

May be associated with use of angiotensin converting

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may be associated with use of angiotensin converting enzyme (ACE) inhibitor drugs Post-transfusion purpura (PTP) o findings: thrombocytopenia, usually profound o typically occurs 7 to 48 days after transfusion Circulatory overload o caused by the infusion of blood at a rate too rapid for the client to tolerate o findings: dyspnea, orthopnea, tachycardia, sudden anxiety, progresses to pulmonary edema if transfusion is continued
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o diuretics given after or between transfusions to clients at risk of, or already in, circulatory overload Transfusion Reactions 3 RN Lesson 6-A Pharmacological & Parenteral Therapies Avoiding transfusion reactions: screening blood donors o volunteer donors preferred - paid donors less likely to report past or present disease o screen for infectious disease: hepatitis, HIV, tuberculosis, syphilis, malaria, international travel, residence in United Kingdom between 1980-1996 blood diseases, abnormal bleeding hypotension, anemia, jaundice, fever high risk behavior: male homosexual or bisexual malignancy, disease of heart, lungs, liver, allergies recent pregnancy, surgery, blood transfusion, vaccinations with attenuated virus, recent piercings, recent tattoos Blood Product Administration - Nursing RN Lesson 6-A Pharmacological & Parenteral Therapies Nursing interventions o Guidelines for administration signed consent forms required for blood administration retrieve the blood from the blood bank area
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together with another RN, compare the blood and the crossmatch slip from the blood bank and compare data with the client's ID bracelet - verify client's name, ID number, blood type and Rh factors, donor number on the blood container and expiration date establish baseline data and monitor (follow agency policy for frequency and duration) vital signs, SaO2, and check skin after first 15 minutes of transfusion, during administration (as per policy), and 1 hour post transfusion breath sounds, crackles, dyspnea, jugular vein distention hemoglobin (Hgb) and hematocrit (HCT), urine output; serum potassium, calcium, and creatinine prime intravenous tubing with normal saline for whole blood administration (never use dextrose solutions - may cause clumping of RBCs) and ensure the insertion site is patent initiate transfusion slowly for 15 to 20 minutes remain at bedside question client about unusual feelings monitor vital signs every 5 minutes or follow agency policy general benign hives may occur return transfusion record to blood bank when infusion is complete most reactions are due to human error occur within the first 15 minutes of a transfusion treat client symptomatically
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notify provider and blood bank Blood Product Administration - Nursing 2 RN Lesson 6-A Pharmacological & Parenteral Therapies Preventing complications o carefully verify documentation related to blood products o do not remove blood product tags or identification o infuse transfusion at prescribed rate or follow agency policy using an infusion control device
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