Blood transfusion therapy

Nursing responsibility o Thrombocytopenia

- Blood type = screening - Administration
Transfusion o 1-2 mL/min
- Administration of any blood products o 5 minutes per single donor bag
Blood transfusion o Given rapidly
- Lifesaving therapy, medical and surgical - Platelet derivatives
conditions in need of blood o Separating and freezing the plasma
o Plasma expander within 8 hours
o Hemorrhage o Uses
National blood service act 1994  Multiple coagulation factor
- Republic act 7719 derivatives
- Act, voluntary blood donation, safe blood  Warfarin
- Eligible donors  DIC
o 18  Massive transfusion
o 110 lbs (50 kg) administration
o Skin diseases  Cryoprecipitate – shelf
o 56 days life of 1 year
o HBG 12.5 gl/dl – women o System
 13.5 gl/dl – men fibrinogen
- Ineligible donors o Chemotherapy
o HIV or AIDS o DIC
o Illegal drugs – IV o Massive
o Sex, prostitutes – past 12 months hemorrhage
o Hepatitis o Hemophilia
o Cancer Administration of blood component
o Received clotting factor, concentrations 1. Recipient consent
Blood collection methods 2. Verifying authorized prescribers order
- Unrelated donor – allogeneic 3. Pretransfusion
- Directed donor 4. Vascular access; selecting and preparing the
- Autologous donor (self) equipment
o Blood donor resources o Increase temperature = hemolysis
Blood components therapy o Cold infusion = venous spasm
- Whole blood – RBC, plasma, WBC, platelets 5. Preparing the patient
- 500 mL, 200 mL of RBC and 300 mL of plasma 6. Dispensing and transportation
with 33% HCT 7. Initiating the transfusion
- Acute, massive blood loss w/ s/sx o Prescriber’s order
o Hypotension o Transfusion consent form
o Dyspnea o Recipient
o Tachycardia o Unit
o Pallor o Blood type
Administration o Expiration
RBC o Compatibility
- 2500350 mL o Appearance
- 20-30% plasma, leukocytes, platelets 8. Monitoring the transfusion
Washed RBC 9. Completing the transfusion
- Severe allergic reactions Documentation
- Wash w/ cellular saline 1. Medication order
Irradiated blood products 2. Consent
- Transfusion associated GVHD 3. Name/type
o Leukemia/lymphoma 4. Donor unit
o Bone marrow 5. Date and time
o Cell transplant 6. VS
o Immunodeficiency 7. Volume transfused
o Neonate and low birth weight infants 8. Transfusionist
Platelets 9. Adverse effects
- 100,000-300,000 Complications
- Room temperature 20-24 C 7 days Acute hemolytic + transfusion reactions
- Single apheresis unit = 6-8 random donor Signs and symptoms
platelets - Fever and tachycardia
Blood transfusion therapy
- Mild
- Severe
- Red/dark urine
- Shock/DIC
Interventions
- Droplet recognition
- Stop infusion
- Discontinue tubing
- Notify physician/blood bank
- VS
- Furosemide
Febrile nonhemolytic febrile reactions
Signs & symptoms
- Fever
- Chills
- Headache
- Vomiting
Interventions
Allergic reactions
- Allergic to the component or less often by
antibodies from an allergic donor
o S/SX:
 Mild – itching, hives, urticarial,
angioedema, deep swelling
around the eyes/hips
 Severe – anxiety,
bronchospasm, wheezing,
hypotension
o Interventions:
 Stop the transfusion
 Keep the vein open with normal
saline
 Notify physician
 Monitor VS
 Antihistamines
 Anaphylactic reaction
o Preventions:
 Mild reaction
 Transfusion related
acute lung injury
 Transfusion associated
circulatory overload