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Blood Transfusion
Nursing Implications
Know the P and P at agency
Patient must have a Type and Crossmatch performed
May premedicate the patient- depends on patient
history of reaction
Need at least a 19g IV for PRBC transfusion to
prevent hemolysis
8/17/2011
Blood Transfusion
If no reaction occurs in the first 15 minutes, the rate
may be increased
Red Blood Cells: two hours unless the patient can
tolerate only gradual expansion of the intravascular
volume
Infusion time should not exceed 4 hours for any
component.
Vital signs should be monitored frequently.
Transfusion Reactions
There are 5 major types of reactions:
1) Hemolytic: caused by incompatibility between
patients blood and donors blood
2) Febrile: caused by sensitivity of the patients blood
to WBCs, platelets, or plasma proteins
3) Allergic: sensitivity to plasma proteins or an
antibody-antigen reaction; may be minor or major
4) Circulatory Overload: caused by blood being
administered faster than the circulation can
accommodate
5) Sepsis: caused by contaminated blood; very rare
Transfusion Reactions
A MAJOR reaction is defined as life
threatening and is a medical emergency. A
hemolytic reaction is the most common major
reaction.
A MINOR reaction is relatively common and is
not life threatening. Febrile and allergic
reactions are the most common minor
reactions
8/17/2011
Chills
Fever
Headache
Backache
Dyspnea
Cyanosis
Chest pain
Itching
Wheezing
Tachycardia
Hypotension
Anxiety
Flushing
8/17/2011
Critical Thinking
You are administering a platelet transfusion to your
patient who has a nosebleed during the transfusion.
Your priority nursing intervention would be:
1.
2.
3.
4.