I.

BLOOD TRANSFUSION
- The introduction of whole blood or
components of the blood
(plasma, serum, erythrocytes or
platelets) into the venous circulation.

 ABO BLOOD GROUP SYSTEM

- TYPE A
o Antigen (A)
o Antibodies (B)
- TYPE B
o Antigen (B)
o Antibodies (A)
- TYPE AB III. RH FACTOR
o Antigen (AB) - Another consideration when matching blood
o Antibodies (none) universal components
recipient - Refers to another antigen in RBC membranes
- TYPE O  Rh (+) has an Rh antigen
o Antigen (none)  Rh (+) does not produce antibody
o Antibodies (AB) universal donor  Rh (-) has no Rh antigen
 Rh (-) produces antibody

 Who can give to whom?

o Rh (+) can donate to Rh (+) but can’t
donate to Rh (-)
o Rh (-) can donate both to Rh (-) and Rh
(+)
 Who can receive from whom?
o Rh (+) can receive Rh (+) or Rh (-)
o Rh (-) can only get Rh (-)

IV. BLOOD TYPES

 A+, A-
 B+, B-
 AB+, AB-
 O+, O-

II. TERMINOLOGIES V. HEMATOLOGIC SYSTEM

 FFP – fresh from plasma  WBC (leukocytes) 4500-11000/cu mm
 PRBC – packed red blood cell o Fights infection
 ANTIGEN – agglutinogens  NEUTROPHIL 45-73%
 Rh – Rhesus o Prevents and limits bacterial infection
 NEUTROPENIA – low neutrophil  MONOCYTES 2-8%
 NEUTROPHILIA – high neutrophil o As macrophage, highly phagocytic,
 MONOCYTOPENIA – low fungus
 EOSINOPHILIA – high  EOSINOPHILS 0-4%
 EOSINOPENIA – low o Allergic reactions
 BASOPHILIA – high  BASOPHILS
 BASOPENIA – low o Contains histamine
 LYMPHOCYTOSIS – high  LYMPHOCYTES 20-40%
 LYMPHOCYTOPENIA – low o Integral component of immune
system
 T LYMPHOCYTES
o Cell-mediated immunity, recognizes
material as foreign body
(surveillance)
 B LYMPHOCYTES
o Humoral immunity, form antibodies
  RBC o 85% of people is Rh (+)
o Carries hemoglobin, average life span
120 days
 PLATELET 150000-400000/mm3 IX. NURSING CARE
o Hemostasis, life span 10 days  Assess history of allergy
 Ensure that the IV catheter is 18 or 19g
 Use .9 Nacl
VI. BLOOD PRODUCTS AND USE  Verify the blood
 Whole blood  Take baseline vital signs
o Replaces blood volume and all blood  Start transfusion slowly
products  Stay with the client during the initial 15min
 Red blood cell  Maintain the transfusion rate
o Increase oxygen carrying capacity of o FWB – (3-4 HRS)
blood o PRBC – (2-4HRS)
 Platelets o FFP, platelets, cryoprecipitate – fast
o Replaces platelets for clients with drip
bleeding disorders or platelet  Monitor adverse reaction
deficiency  Document the ff:
 Fresh from plasma o Blood component and number
o Expands blood volume and provides o Infusion started and ended
clotting factors o Client reaction
 Autologous red blood cell
o Use for blood replacement following
planned elective surgery
X. MATERIALS NEEDED
 Clotting factors and cryoprecipitate
 IV tray
o Used for clients with clotting factors
 Compatible BT set
deficiencies
 IV catheter /needle g 18/19
 Albumin and plasma protein factor
 Plaster
o Blood volume expanders provides
 Tourniquet
plasma proteins
 Blood product
 Plain NSS
 IV stand
VII. BLOOD TRANSFUSION PURPOSE
 Gloves
- To increase O2 carrying capacity of blood as
in anemia
 INITIATING BLOOD THERAPY
- To replace circulating blood volume or as
- Verified health care provider’s order for
volume expansion (WB) for cases of
specific blood of blood product and all
hemorrhage
pertinent information
- Provision of protein
- Provision of coagulation factors XI. HEMOLYTIC REACTION
(cryoprecipitate, FFP, FWB) - Blood donor is incompatible with the recipient
- To prevent bleeding if there’s platelet blood
deficiency - Most fatal, may present chills, diaphoresis and
- To combat infection if there’s decrease WBC back pains

 SIGNS AND SYMPTOMS

o Headache
o Dizziness
o Dyspnea
o Palpation and tachycardia
o Lumbar/sterna/flank pain
o Hypotension
VIII. NURSING MGT & PRINCIPLES IN o Flushed skin’
BLOOD TRANSFUSION o (red) pot wine urine
- Proper refrigeration  NURSING MGT.
- Proper typing & cross matching o Stop BT- remove and change the tubing
o TYPE O – universal donor o Notify doc
o AB – universal recipient o Flush with plain NSS
 o Administer isotonic fluid solution to o Dyspnea
counteract shock o Orthopnea
o Send blood unit to blood bank for o Rales & crackles
reexamination o Tachycardia and hypertension
o Obtain urine & blood samples of pt &
send to lab for reexamination  NURSING MGT.
o Monitor VS & allergic reaction o Stop BT and place the client upright with
feet dependent
XII. ALLERGIC REACTION o Notify doc, don’t flush due pt has
- Rashes and itchiness, dyspnea, bronchospasm circulatory overload
due to sensitivity in foreign proteins in plasma o Administer diuretics
 SIGNS AND SYMPTOMS
o Fever/chills
o Urticaria/pruritus XV. SEPSIS
o Dyspnea - Contaminated blood administered
o Laryngospasm/bronchospasm
o Bronchial wheezing  WATCH OUT FOR:
 NURSING MGT. o High fever
o Stop BT o Chills
o Notify doc o Vomiting
o Flush with PNSS o Diarrhea
o Administer antihistamine – o Hypotension
diphenhydramine Hd (Benadryl)
o If (+) hypotension – anaphylactic shock.  NURSING MGT.
administer – epinephrine o Stop
o Send blood unit to blood bank o KVO with NSS
o Obtain urine & blood samples – send to o Notify the MD
lab o Administer IVF and antibiotics as ordered
o Monitor VS & IO
o Administer antihistamine as ordered for  PRIORITY CASES
allergic reaction o 1ST HEMOLYTIC REACTION -due to
o Administer antipyretic & antibiotic for hypotension- attend to destruction of Hgb
pyrogenic reaction & TSB -O2 brain damage
o 2nd CIRCULATORY OVERLOAD
o 3rd -ALLERGIC REACTION
XIII. PYROGENIC REACTION o 4TH - PYROGENIC
- Fever and chills due to sensitivity to leukocyte
or platelet antigen – most common

 SIGNS AND SYMPTOMS

o Fever/chills
o Tachycardia
o Headache
o Palpations
o Dyspnea
o Diaphoresis

 NURSING MGT.
o Stop BT
o Notify doc
o Flush with PNSS
o Administer antipyretics, antibiotics
o Send blood unit to blood bank
o Obtain urine & blood samples -send to lab
o Monitor VS & IO

XIV. CIRCULATORY OVERLOAD

 SIGNS AND SYMPTOMS