BLOOD TRANSFUSION NUR 317. TRANSFUSION Infusion of blood products for the purpose of restoring...
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Transcript of BLOOD TRANSFUSION NUR 317. TRANSFUSION Infusion of blood products for the purpose of restoring...
BLOOD TRANSFUSION
NUR 317
TRANSFUSION
• Infusion of blood products for the purpose of restoring circulating volume.
• May be whole Blood or blood components• Platelets
• Plasma
• PRBC
• Albumin
Administering Blood Products
• Leukocyte-free PRBC: • Most WBCs removed to reduce risk of reaction
• Whole blood: • Most common blood product given in the hospital
• Used to treat shock, low blood volumes, low hematocrit and hemoglobin, hemorrhage
• Packed RBCs:• Separated from plasma
• Used to treat anemia, and reduce risk of volume overload
Administering Blood Products
• Fresh frozen plasma (FFP): • Used to restore plasma volume, treat some bleeding
problems
• separated from whole blood by a centrifuge process
• Platelets• Maintain normal coagulability of blood
• Used to treat some bleeding disorders, and to compensate when marrow can not produce enough
Blood Supply Safety
• Once blood has been received from the donor it is immediately tested for blood type and infectious diseases
Type and Crossmatch
• Blood undergoes “type and crossmatch”: • Typing to determine ABO and Rh factor
• Crossmatching to determine compatibility between donor and recipient blood
• ANTIGEN: is a substance that prompts the generation of antibodies
• ANTIBODY: are proteins that are found in blood and are used to identify and neutralize foreign objects, such as bacteria and viruses
4 types
• A
• B
• AB
• O
Blood Typing
• The Rh factor is made up of numerous complex antigens • When it is present, the person is Rh positive (Rh+); if not
present, the person is Rh negative (Rh–)
Blood Typing
• An Rh positive person may receive either – or + blood
• An Rh negative person must receive only Rh– blood • If an Rh– person receives Rh+ blood, antibodies will form
• If another transfusion of Rh+ blood is given, the antibodies will agglutinate with the Rh antigens of the blood being transfused
Blood compatibilities
Blood typing for transfusion
• Universal donor= O-• Does not contain A, B, or Rh antigens
• Universal recipients= AB+• Blood contains A, B, and RH antigens
• Usually blood banks exactly match the pt blood
Blood Screening
• Prior to be being released for patient use
• testing for:• Hepatitis C
• Human immunodeficiency virus (HIV)
Infusion Therapy Risks• Risk factors:
• Disease transmission• Hepatitis B
• Hepatitis C
• Hepatitis A
• HIV
• Syphillis
• Bacterial contamination
• Acute or delayed transfusion reactions• Allergic reactions
• Mismatched ABO
• Incompatible Death
• Circulatory overload
Infusion Therapy Hazards
• Some risks specific to massive transfusion (replacement of > one blood volume in 24 hours):
• Hypothermia
• Hemodilution
• Platelet dysfunction
• Electrolyte problems
ADMINISTRATION PROCESS
• ASSESS Transfusion history• Previous transfusions, allergies and reactions
• Type of transfusion reaction, manifestations, and treatment
Interventions
• Once the blood has been taken from the blood bank, it must be administered within 30 minutes
• The nurse must ensure: • Positive patient identification
• Appropriateness of blood component
• Blood product inspection
• Verification of donor – recipient compatibility
• Verification of product expiration date
administration of blood
• 18 or 20 gauge IV canula
• blood needs to be checked by 2 licensed nurses.
• Check expiration date, name, medical record number, type of blood, blood band id, pt age
• Check vitals prior to administration
• **blood must be initiated with in 30 minutes of arrival from bank to floor
• Use blood tube for administration
• Monitor for blood reactions
• Monitor vitals continuously during administration
• Circulatory overload: • Dyspnea
• Tachycardia
• Cough
• frothy sputum
• Cyanosis
• increased BP that drops suddenly
• distended neck veins
• crackles
Y-type blood tubing