IV THERAPY AND BLOOD

TRANSFUSION

by: ROMAN J-LOU B. CORDOVILLA, MAN, RN, RM, EMT-B

LEGAL ASPECTS IN INTRAVENOUS
THERAPY
RA 7164 Sec. 27 Art. IV Defines Scope of Nursing Practice

Utilization of the nursing process including APIE of

nursing care. Nursing care includes, but is not limited
to traditional and innovative approaches in nursing,
therapeutic use of self, executing nursing procedures
and technique, comfort measures, health teaching,
administration of legal and written prescriptions for
treatment, therapies, medications, and hypodermic, IM
or IV injections, provided that in IV injections, Special
training shall be required and according to protocol
established.
Implementing Guidelines of RA 7164
“IV injections shall include IV administration of drugs,
fluids and electrolytes, blood and blood products. It shall
include insertion of needles/butterfly in IV infusions”

Guidelines on the training of nurses on IV injection shall be

formulated by the Board of Nursing in consultation with the
Philippine Nurses Association (PNA) and the Association of
Nursing Service Administrators of the Philippines (ANSAP)
What is intravenous (IV) therapy?
Insertion of a needle of catheter cannula into a vein
based on physician’s written prescription. The
needle or catheter cannula is attached to a sterile
tubing and fluid container to provide medicine and
fluid.
Purpose
1. To maintain or correct dehydration in

clients unable to tolerate sufficient

volume of oral fluids/medicine
2. Parenteral nutrition
3. Administer drugs
4. Transfusion of blood or blood
components
5. To provide a lifeline for rapidly
needed medications or blood
 Indications

-Establish or maintain a fluid or electrolyte balance

-Administer continuous or intermittent medication
-Administer bolus medication
-Administer fluid to keep vein open (KVO)
-Administer blood or blood components
-Administer intravenous anesthetics
-Maintain or correct a patient's nutritional state
-Administer diagnostic reagents
-Monitor hemodynamic functions
IV Therapy
 Intravenous therapy is prescribed
 to persons requiring electrolyte replacement, fluid,
calories, vitamins, or other nutritional substances.
 for administration of medications, chemotherapy or
for transfusion of blood products.
The intravenous route is the fastest way to
deliver fluids and medications throughout
the body.

Some medications, as well as blood

transfusions and lethal injections, can only
be given intravenously.
 KEY POINTS TO INITIATION OF
IV THERAPY
 Physician’s prescribed treatment. The initiation of
IV therapy is upon the written prescription of a
licensed physician which is checked for the following:
 Patient’s name
 Type and amount of solution
 The flow rate
 The type, dose and frequency of medications to be
incorporated/ pushed.
 Others affecting the procedures (x-ray, treatments to the
extremities ,etc.)
 Patient Assessment
 Factors to consider for IV Therapy:
 Clinical Status of patient
 Patient diagnosis
 Patient’s age
 Dominant Arm (Non)
 Condition of vein/skin
 Cannula size
 Type of solution
Common Types
of IV
Solutions
1. Colloids

 contain proteins or other molecules of high molecular

weight that tend to remain intravascular for long
periods of time.

 They exert osmotic pressure (the pressure generated

by the tendency of water to follow high
concentrations of molecules) thus, they draw
interstitial and intracellular water toward the
intravascular fluid compartment. (Whole blood,
plasma, packed red cells, plasma substitutes, Dextran,
Hespan, Plasma Protein Fraction Plasmanate)
2. Crystalloids
 solutions made by dissolving crystals into water.
They are good fluid replacers and are categorized
by tonicity the amount of particle present in a
solution.
 Types of
Crystalloids
a. Hypotonic solutions
 haveless dissolved particles than plasma, good
route for medications but not good choice as fluid
replacers because it leaves the vascular space
(D5W)
Example: D5 0.45 (5% dextrose
in 1/2 normal saline).
b. Hypertonic solutions
 have more dissolved particles than plasma and
have initial effect of drawing water form
intracellular spaces to intravascular space but once
sugar content is metabolized, solution becomes
hypotonic (D5LR, D10W, D5 0.45%NaCl)
Examples: D5 0.9% NaCl, blood
products, and albumin.
INDICATIONS
Establish or maintain a fluid or electrolyte balance
Administer continuous or intermittent medication
Administer bolus medication
Administer fluid to keep vein open (KVO)
Administer blood or blood components
Administer intravenous anesthetics
Maintain or correct a patient's nutritional state
Administer diagnostic reagents
Monitor hemodynamic functions
c. Isotonic solution
 have roughly the same
amount of dissolved
particle as plasma and good
choice for fluid
replacement (NSS, LR)
 Examples: Lactated Ringer's
(LR), NS
 (normal saline, or 0.9% saline in
water).
Sites for IV
Infusion
 IV set and equipment preparations
 Check for expiration date
 Check for clarity; any presence of holes on plastic cover
(packaging); plastic container (bag) for presence of
sediments or insects.
 Check labels against the physician’s written prescription.
 Label for any medication that are added: date, time, dose of
administration of medication and amount, compatibility of
drug with the solution.
 Functionality of infusion pump, Patient Controlled analgesia
(PtCA)
Medications
 Nurses administering IV therapy should have knowledge on
all medications administered including dosages, drug
interactions and possible clinical effects on the vascular
system.
Company and Drop Factors
Company Name Drop factor (qtts/ml)

 Abbott 15
 Baxter-Travenol 10
 IVAC 20
 INSET 20
 B. Braun 15
Choice of Cannula for

The factors to consider for the choice of cannula are:

Peripheral Infusion

 Purpose of the infusion.

 Type of infusion
 Size and condition of the patient’s vein
 Duration of treatment
 Condition of Patient.
 CANNULA SIZE AND APPLICATION
Cannula size Application
14, 16, 18 - gauge Trauma, surgery, blood
transfusion
20- gauge Continuous or intermittent
infusions; blood transfusion

22- gauge Intermittent general infusion,

children and elderly

24-gauge Fragile veins for intermittent

or continuous infusion

(source: INS)
INTRAVENOUS
SOLUTION
AND
STERILE
IV TUBING
Figure 50.17 A plastic intravenous fluid container
and IV tubing

© Elena Dorfman
Peripheral IV lines
 The most common intravenous access method in both
hospitals and paramedic services.
 A peripheral IV line consists of a short catheter (a
few centimeters long) inserted through the skin into a
peripheral vein, any vein that is not in the chest or
abdomen.
♣Arm and hand veins - typically used
♣ Leg and foot veins - occasionally used.
♣ infants - scalp veins are sometimes used.
PERIPHERAL IV LINE
Vein Selection
Veins of the Hand
1.Digital Dorsal veins
2. Dorsal Metacarpal veins
3. Dorsal venous network
4. Cephalic vein
5. Basilic vein
 Veins of the Forearm
1. Cephalic vein
2. Median Cubital vein
3. Accessory Cephalic vein
4. Basilic vein
5. Cephalic vein
6. Median antebrachial vein
IV SITES FOR INFANTS
IV SITE FOR INFANTS
CONSIDERATION IN THE SELECTION OF
THE SITE

1. Select a vein large enough to accommodate the

needle that will be used
2. Type of solution
3. Client’s age
EQUIPMENT
A. Container of Sterile Intravenous Solution

1. IV solutions comes
in different sizes:

a. 150 ml

b. 250 ml
c. 500 ml
d. 1000 ml
2. Solutions should be sterile and in proper
condition

a. Check expiration date

b. There should be no particulate matter in

the solution

c. Check for any leaks indicative

of contamination
B. Administration set

1. Macrodrip or
Macroset (10, 15, or
20 drops per ml of
solution)
2. Microdrip or microset (60 drops per ml of solution)
A. insertion spike – inserted into
the solution
container and kept sterile
B. drip chamber – to prevent air
from entering the line
C. roller or screw clamp – to
control the rate of flow of the
solution tubing
E. protective cap – maintains the
sterility of the end of the
tubing so that it can be
attached to sterile needle
inserted in the client’s vein
F. needle adapter
3. Volume-control set or soluset
4. Blood Transfusion Set
C. IV Poles
- the higher the solution
container is suspended,
the greater the force of
the solution as it enters
the client and faster the
rate of flow.
D. Intravenous needle or catheter
Butterfly or wing-tipped needles (25 to 17 gauge)
They are named after the wing-like plastic tabs at the
base of the needle. They are used to deliver small
quantities of medicines, to deliver fluids via the scalp
veins in infants, and sometimes to draw blood samples
(although not routinely, since the small diameter may
damage blood cells). These are small gauge needles (i.e.
23 gauge).
2. Catheter or IV cannula
- The larger the gauge number, the
smaller the diameter of the shaft

Example: peripheral IV catheter. This is the kind of

catheter you will primarily be using.
Needle gauge (Catheter)
E. IV Tray

- contains sterile swabs, antiseptic solution, plaster,

tourniquet, splint, local anesthetic, sterile 2x2
gauze squares
The initiation of IV Therapy is upon the written prescription of a
licensed physician which is checked for the:
a. Type the solution
b. Flow rate
c. Amount of solution
d. Dose and frequency of medicine
to be incorporated
TIME TO CHANGE
 Be aware of the following clinical indicators that
necessitate the change of catheter site:
 Erythema and pain or tenderness at the insertion site or
along the vein;
 Discharge at the insertion site;
 Blanching above or at the site;
 Tenderness not resolved by slowing the infusion or the
application of the warm compresses
 Patient complaints of actual pain and not just tenderness
at either the insertion site or long the vein
LOCAL IV COMPLICATIONS
-Infiltration and extravasation
-Phlebitis
-Thrombophlebitis
-Hematoma
-Clogging of the Needle
 Infiltration
 Causes
 Needle or catheter displacement
 Leakage of blood around the needle
or catheter
 Signs and Symptoms
 Coolness of skin around the site
 Swelling around the site, which may
or may not be painful
 Swelling of the entire limb
 Absence of backflow
 Significant decrease in flow rate
 HOW TO CHECK
 Insertion area is larger than the same site of the opposite
extremity
 Apply a tourniquet above or proximal to the infusion site and
tighten it enough to restrict venous flow.
 If the infusion continues to drip despite the venous
obstruction, infiltration is present
Nursing Considerations
 STOP the infusion, IV discontinued, a sterile dressing applied
to the site after careful determination.
 If the infiltration is caught within a half hour and the swelling
is small, apply ice, otherwise use a warm compress to
reabsorb edema fluids and reduce swelling.
 Restart the IV in another limb or proximal to the infiltration if
the same extremity is used
 Prevention
Inspect the site every hour for redness, pain,
edema, blood return, coolness of the site, IVF
draining from IV site.
Use appropriate size and type of cannula from
the vein
Use a standardized infiltration scale to
document infiltration
 INFUSION NURSING
STANDARDS OF PRACTICE
0 = NO SYMPTOMS
1 = skin blanched, edema less than 1 inch in any direction, cool to
touch, with or without pain
2= skin blanched, edema 1-6 inches in any direction, cool to touch,
with or without pain
3 = skin blanched, translucent gross edema greater than 6 inches in
any direction, cool to touch, mild to moderate pain, possible
numbness
 INFUSION NURSING STANDARDS OF
PRACTICE
4 = skin blanched, translucent, skin tight,
leaking, skin discolored, bruised, swollen,
gross edema greater than 6 inches in any
direction, deep pitting tissue edema,
circulatory impairment, moderate to severe
pain, infiltration of any amount of blood
products, irritant or vesicant.
EXTRAVASATION
 Causes
 Medications like dopamine,
chemotherapy agents, certain
electrolyte solutions (e.g.
potassium and calcium),
antibiotics (e.g. vancomycin),
promethazine, diazepam, and
phenytoin, radiographic contrast
media, and vasopressors
Signs and symptoms of Extravasation
 severe pain or burning during infusion;
 blotchy redness around the insertion site;
 edema at the insertion site;
 slowing or
 stopping of the infusion rate.
NURSING INTERVENTIONS
 The infusion must be stopped and the physician
notified promptly.
 Carry out established protocols for extravasations
immediately
 Catheter is left in place until residual medication and
blood are aspirated
 If known, antidote specific to the vesicant is instilled
into the tissue
NURSING INTERVENTIONS
 Apply sterile dressing to the site after
removal of the catheter
 Apply cold compresses to an extravasation
of an alkylating and antibiotic vesicant, and
warm compresses to an extravasation of the
vinca alkaloids
 Elevate extremity regularly and observe for
pain, erythema, induration and necrosis
NURSING INTERVENTIONS
 Establish a new catheter insertion site in the
opposite extremity, if possible
 Choose a site above and away from extravasated site
if use of the opposite extremity is contraindicated
 Consider using a central vascular access device
NURSING INTERVENTIONS
 Educatethe patient to monitor the siter for several
weeks after an extravasation occurs
 Tissue necrosis may not develop for 1 to 4 weeks
 Surgical intervention may become necessary if tissue
necrosis is severe
 PREVENTION
 Careful, frequent monitoring of IV site
 avoiding insertion of IV devices in areas of flexion
 Securing IV line
 Using the smallest catheter possible that accommodates the vein
 Extravasation should always be rated as a grade 4 on the
infiltration scale
Thrombophlebitis
Cause
Injury to the vein, either during
venipuncture or from needle movement
later
Irritation to the vein caused by the
following long-term therapy, irritating or
incompatible additives, or use of vein
that is too small to handle the amount or
type of solution
Sluggish flow rate which allows clot
formation at the end of the needle or catheter.
Overuse of vein, use of irritating solutions,
clot formation, large bore catheters.
 Signs and Symptoms
1.Sluggish flow rate
2.Edema in the limb
3.A vein that is sore, hard, cord like and warm to
touch.
4.May look like a red line above the venipuncture
5.Pain along the course of vein.
6.Immobility of the extremity
7. Fever
8. Leukocytosis
 Nursing Considerations:
Thrombophlebitis

Discontinue the infusion and remove the

needle or catheter immediately.
Notify the doctor
 Elevate the extremity and restart the IV in
another limb
Change IV site every 72 hours.
Nursing Considerations:
Thrombophlebitis
 Use large veins for irritating fluids.
 Stabilize venipuncture at area of flexion.
 Apply cold compress immediately to relieve pain
and inflammation; later follow with warm
compress to stimulate circulation and promote
absorption.
PREVENTION
 Avoid trauma to the vein at the time the IV is
inserted
 Observe the site every hour
 Check medication additives for compatibility
PHLEBITIS
Inflammation of a vein related to
chemical or mechanical irritation
 PHLEBITIS

Signs and Symptoms

 Reddened, warm area around
the insertion site or along the
path of vein
 Pain or tenderness at the site
or along the vein and
swelling
NURSING INTERVENTION
 Discontinuethe IV starting in another site
 Apply a warm, moist compress to the affected site.
PREVENTION
 Use aseptic technique during insertion
 Use appropriate size cannula or needle for the
vein considering the composition of the fluids
and meds
 Observe the site hourly for any complications
 Anchor the cannula well
 Change the IV site according to agency policy
and procedures
HEMATOMA
-Results when blood leaks into tissues surrounding
the IV insertion site
-Leakage can result from perforation of the opposite
vein wall during venipuncture, the needle slipping
out of vein, and insufficient pressure applied to the
site removing the needle or cannula
 HEMATOMA
Signs and symptoms
 ecchymosis
 Immediate swelling at the site
 -leakage of blood at the site

Bruising after multiple

attempts to find a vein
 BRUISING


 TREATMENT
 Removing the needle or cannula and applying pressure with a
sterile dressing
 Apply ice for 24H to the site to avoid extension of the
hematoma and then a warm compress to increase absorption of
blood
 Restarting the line on the opposite extremity if indicated
PREVENTION
Carefully inserting the needle
Use diligent care when a patient
has bleeding disorder, takes
anticoagulant medication or has
advanced liver disease
 CLOTTING AND OBSTRUCTION

Blood clots may form in the IV SIGNS

line as a result of
 kinked IV tubing,
-DECREASED
 a very slow infusion rate
flow rate and
 An empty IV bag blood back flow
 Failure to flush the IV line into the tubing
after intermittent medication
or solution administrations
NURSING INTERVENTIONS
 The infusion must be discontinued and restarted in
another site with a new cannula and administration
set
 The tubing should not be irrigated or milked
 Neither the infusion nor the solution container
should be raised and the clots should not be
aspirated from the tubing
PREVENTION
 Do not permit the IV to run dry
 Tape the tubing to prevent kinking and maintain
patency
 Maintain an adequate flow rate
 Flushing the line after intermittent medication or
other solution administration
 In some cases, a specially trained nurse or physician
may inject a thrombolytic agent into the catheter to
clear an occlusion resulting from fibrin or clotted
blood.
 Nerve Damage

 May result from tying the arm too tightly to the

splint.
 Assessment
 Numbness of fingers and hands
 Nursing Interventions
 Massage area and move shoulder through its ROM
 Instruct the patient to open and close hand several times
each hour
 Physical therapy may be required

 Note: Apply splint with the fingers free to move.

 Circulatory Overload
 Causes
 Fluid delivered too fast
 Hepatic, cardiac or renal
diseases
 Signs and Symptoms
 Rise in blood pressure and
CVP
 Dilatation of veins
 Rapid breathing, SOB,
rales
 Wide variance between
input and output
 Nursing Considerations
 Slow the infusion to KVO
rate
 Raise the patient’s bed to
ease breathing
 Keep him warm to
promote circulation and
ease the stress on central
veins
 Monitor VS
 Administer O2, diuretic,
bronchodilator as
ordered.
 Notify the doctor
 Document
TREATMENT PRECAUTION
 Decreasing the IV rate  Use of IV pump
 Monitoring VS frequently  Careful monitoring of all
 Place on fowlers position infusions
 Contact physician COMPLICATIONS
immediately  Heart failure and pulmonary
edema
 Air Embolism
 Signs and Symptoms
 Poses a great risk  BP drop
 More common in central 
Rise in CVP
than peripheral lines  Weak, rapid pulse
 Cyanosis
 Possible causes
 Loss of consciousness
 Container allowed to  Chest, shoulder and low back
run dry pain
 dyspnea
 Air in tubing
 Loose connections
TREATMENT PREVENTION
 Immediately clamp the  Fill all tubing completely
cannula with solution
 Place on left side in the  Use an air detection alarm
trendelenburg position on an IV pump
 Assess VS COMPLICATIONS
 Administer O2  SHOCK
 DEATH
Nursing Considerations
AIR EMBOLISM
 Discontinue the IV
 Apply tourniquet above the site.
 Have the patient x-rayed to confirm the embolism
 Document
 Catheter Embolism
 More common with inside-  Signs and Symptoms
the-needle catheters than
with outside-the-needle
catheters
 Causes
 Withdrawing the catheter
before the needle or
attempting to rethread a
catheter with a needle
 Failure to secure the
catheter to the skin
adequately
 Discomfort along the vein
in which the catheter
fragments lodged.
 BP drop
 Increased venous
pressure
 Weak, rapid pulse
 Cyanosis
 Loss of Consciousness
 Dyspnea
Nursing Considerations
 Turn the patient on his left in the trendelenburg
position. To allow air to rise in the right side of
the heart to prevent pulmonary embolism.
 Prime IV tubing before starting infusion.
 Do not allow IV bottle to “run dry”
 Lower the head of the bed
 Check the system for leaks
 Give 02 if allowed
 Notify the doctor immediately
 Infection of Venipuncture Site
  Nursing Considerations
Causes
 Poor aseptic technique  Discontinue the infusion

 Failure to keep the site clean  Remove the needle or catheter

 immediately
Signs and Symptoms
 Send IV equipment to the lab for
 Swelling
bacterial analysis.
 Soreness at the site
 Clean the site. Apply
 Foul-smelling discharge
antimicrobial agents
 Restart IV in another limb
 Document
Systemic Infection
 Nursing Interventions
 More common with plastic
catheters than in metal needles
 Causes
 Poor aseptic technique
 Contamination of
equipment
 Irrigation of clogged IV
 Signs and Symptoms
 Sudden rise in temperature
and pulse
 Chills and shaking
 Blood pressure changes
 Look for other sources of
infection first. Culture
urine, sputum and blood
as ordered
 Discontinue the IV.
 Send all equipment to the
lab.
 Restart the IV in another
limb
 Notify the doctor
 Document.
 INFECTION
Speed Shock
 Causes
 Drugs administered too
quickly
 Improper administration
of bolus infusions
 Signs and Symptoms
 Flushed face
 Headache
 Tight feeling in the chest
 Irregular pulse
 Loss of consciousness
 Shock
 Cardiac arrest
 Nursing Interventions
 Discontinue the drug infusion
 Begin an infusion of 5%
dextrose in water at KVO
rate.
 Notify the doctor
 Document what you’ve done
 To avoid speed shock, and
possible cardiac arrest, give
most IV push medications
over 3 to 5 minutes.
Allergic Reaction
 Causes Nursing Interventions
 Sensitivity to an IV Slow infusion to KVO
fluid rate
 Signs and Symptoms Notify your doctor
 Itching
Document what
 Rash
you’ve done
 Shortness of Breath
 Technique

 It is important to point out that starting an IV is an

art-form which is learned with experience
accumulated after performing many IVs. Some
patients are easy but many are difficult.
 Preparation
 It is important to gather all the necessary
supplies before you begin
SCOPE OF INFUSION CARE
A. Duties and Responsibilities of Intravenous Therapy Nurse

The IV Therapy Nurse shall be committed

and competent in all aspects of IV therapy to
ensure safety and quality of patient care.
He/she shall perform the following
procedures but is not limited to:
1. Utilizing the nursing process in the care of patient with
IVT:
a. assessment
b. plan of care
c. implementation
d. evaluation
e. documentation
2. Carrying out of the physician’s written prescription for
IV therapy

3. Preparing the necessary materials and observing the

inaccuracy/error/unusualities, which include but are
not limited to the following:
a. expiration date of IV solution and
material
b. cracks of IV bottles
c. presence of sediments and cloudiness
of IV solution
d. incompatibilities of Drugs and solutions
4. Performing peripheral venipuncture to the patients
using all types of needles and cannula excluding, central
lines such as subclavian, internal, external jugular, femoral
lines and in accordance to the established institutional
policy/protocol.

5. Administering blood and blood components as

prescribed by the physician.
6. Computing and establishing, flow rates of solutions,
medications, blood and blood component as prescribed by
the physician.

7. Observing and assessing all adverse reactions related to

IV therapy and initiating necessary measures to avert
reactions.

8. Adhering to established infection control practices.

9. Ensuring technical capability in the use, care,
maintenance and evaluation of IV equipment such as
infusion pumps, syringe pumps etc.

10. Documenting information related to the preparation,

administration and termination of all forms of IV Therapy.
B. Functions of IV Therapy Nurse
Communicator
The IV Therapy nurses shall possess verbal and
written communication skills in translating and
communicating ideas and facts to the patients,
health care members and others.
Coordinator and collaborator
The IV Therapy nurses shall coordinate and
collaborate with other health care provider in all
aspects of IV Therapy based on established quality
control programs and protocol. The IV
Therapy nurses shall participate in:
a. Hospital related communication
b. Continuing education programs related to IV
Therapy
c. Other activities related to IV Therapy
Educator
patient education
IV Therapy nurses shall have the responsibility of
educating patients and significant others o
pertinent aspects of UV Therapy.

Staff Educator
Therapy nurses shall actively participate and
share knowledge with other professionals.
Manager and Supervisor
The IV Therapy nurses shall establish parameters for
evaluation and review of IV Therapy care/services
and shall be accountable for their decisions. They
shall be capable of supervising others under their
jurisdiction.
Researcher
The IV Therapy nurses believe that
research is an inherent component of IV
Therapy nursing. Thus, the IV Therapy nurses
shall initiate, participate in investigation,
validations and development of this aspect of
nursing practice. They shall engage I the
dissemination of research results or outcomes
for improvement.
BLOOD
TRANSFUSIO
N
Definition:

The introduction of whole blood or components of the blood

(plasma, serum, erythrocytes, or platelets) into the vein.
PURPOSES:
1. To increase the circulating blood volume
as in shock due to hemorrhage
2. To increase red cell volume of hemoglobin
content to the blood as in anemia
3. To increase WBC content of the blood as in
agranulocytosis and leukopenia
4. To increase the quality of protein
malnutrition, excessive loss of protein
from burns or vesicular skin disease.
 Materials Needed
 IV tray
 compatible BT set
 IV catheter/needle g 18/19
 Plaster
 Tourniquet
 Blood product
 NSS
 IV stand
 Gloves
 Adverse Reactions
1. Circulatory overload
2. Sepsis
3. Febrile reaction
4. Allergic reaction
5. Acute hemolytic reaction
Transfusion
Products
WHOLE BLOOD
Preparation:
500 ml; 200 ml RBC
& 300 ml Plasma

Indication:
For massive blood loss and exchange transfusion
in neonates
PACKED RBC
Preparation:
350-400 ml; 200-250 ml RBC & 150 ml
Plasma & additive solution (saline,
glucose, mannitol)

Indication:
For adequate oxygen-carrying capacity
PLATELETS
Preparation:
30-60 ml; half the number of platelets originally found in
1 unit Whole Blood

Indication:
For thrombocytopenia, acute leukemia, to restore platelet
count preoperatively
FRESH FROZEN PLASMA
Preparation:
200-250 ml; contains all coagulation
factors and 250 mg of fibrinogen

Indication:
To expand plasma volume, treat post
operative hemorrhage or shock, and correct
coagulation factor deficiencies
CRYOPRECIPITATE
Preparation:
Frozen 20 ml unit contains mostly
coagulation factor VII and 250 mg fibrinogen

Indication:
For hemophilia A
GRANULOCYTES
Preparation
Contains mostly granulocytes and
RBC’s, plasma, and platelets

Indication:

For severe gram negative infection

or severe neutropenia unresponsive
to routine forms of therapy in
immunosuppressed patients
SERUM ALBUMIN & PLASMA
PROTEIN FRACTION (PPF)
Preparation:
25% Albumin in 50 ml and 100ml units
5% Albumin and PPF comes in 250 ml
units
Indication:
For hypovolemia and hypoproteinuria
 BLOOD
TYPE
INDENTIFICATIO
N
CLIENT COMPATIBLE TRANSFUSION

PLASMA RBC
Type A Type A or AB Type A or O
Type B Type B or AB Type B or O
Type AB Type AB Type A, B, AB or O
Type O Type A, B, AB or O Type O
Rh - Must receive Rh- Blood

Rh + Can receive Rh – or Rh
+
O- Universal Donor for
RBC
AB + Universal Donor for
Plasma
Blood Administration Set
 10 Golden Rules for Administrating
Drugs Safely
1. Administer the right drug.
2. Administer the right drug to the right patient.
3. Administer the right dose.
4. Administer the right drug by the right route.
5. Administer the right drug at the right time.
6. Document each drug you administer.
7. Teach your patient about the drugs he is receiving.
8. Take a complete patient drug history. (There is risk of adverse
drug reactions, when a number of drugs are taken or when patient
is taking alcohol drinks)
9. Find out if the patient has any drug allergies.
10. Be aware of potential drug – drug or drug food interactions. To
protect your patient and your license, follow these guidelines for
avoiding medication errors.