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    BLOOD TRANSFUSION

    The transfer of blood or blood components from oneperson (the donor) into the bloodstream of anotherperson (the recipient). This may be done as alifesaving maneuver to replace blood cells or blood

    products lost through bleeding. Transfusion of yourown blood (autologous) is the safest method butrequires advance planning and not all patients areeligible. Directed donor blood allows the patient toreceive blood from known donors. Volunteer donorblood is usually most readily available and, whenproperly tested has a low incidence of adverseevents. Blood conserving techniques are animportant aspect of limiting transfusion

    requirements.

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    BLOOD AND BLOOD COMPONENTS

    COMMONLY USED IN INFUSION

    THERAPY

    BLOOD/BLOODCOMPONENTS

    INDICATIONS AND CONSIDERATIONS

    WHOLEBLOOD

    Packed redblood cells

    (PRBCs)Platelets random

    Volume replacement and oxygen-carrying capacity;usually used only in significant bleeding (.25% blood

    Volume lost)

    Increases RBC mass.Symptomatic anemia: platelets in the units are not

    functional;WBCs in the unit may cause reaction and arenot functional.

    Bleeding due to severe decrease in platelets.Prevent bleeding when platelets

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    BLOOD/BLOODCOMPONENTS

    INDICATIONS AND CONSIDERATIONS

    Platelets single

    donor

    Plasma (FFP)

    Granulocytes

    Lymphocytes (WBCs)

    (apheresed)

    Cryoprecipitate

    Antihemophilic factor

    (AH

    F)

    Used for repeated treatment: decreases

    alloimmunization risk by limiting exposure to multipledonors.

    Bleeding in patients with coagulation factordeficiencies,plasmapheresis.

    Severe neutropenia in selected patients; controversial.

    Stimulate graft-versus-disease effect.

    VonWillebrands diseaseHypofibrinoginemia

    Hemophilia A

    Hemophilia A

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    Transfuse at prescribed rate during prescribedtime, as tolerated by patient.

    Observe for acute reactions allergic, febrile,septic, hemolytic, air embolism, and circulatoryoverload by assessing vital signs, breathsounds, edema, flushing, urticaria, vomiting,

    headache, back pain. Notify patients health care provider or available

    house officer if signs of reaction or otherabnormality arise.

    Be aware of delayed reactions and educatepatient on risk and what to look for: hemolytic,iron overload, graft-versus-host disease,hepatitis, and other infectious diseases.

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    Nursing ConsiderationsBefore administration

    Rationale

    1. Assess laboratory values.

    2. Verify the medical prescription.

    3. Assess the clients vital signs, urineoutput, skin color, and history of

    transfusion reaction.

    4.Obtain venous access. Use a centralcatheter or 19-gauge needle ifpossible.

    5.With another registered nurse,

    verify the clients name and numbercheck blood compatibility, and note

    expiration time.

    Many institutions have specific guidelines

    for blood product transfusions.

    Legally, a physicians prescription is

    required for transfusion. The order shouldstate the type of product, dose, and

    transfusion time.

    Determine whether the client can tolerateinfusion. Baseline information may be

    needed to help identify transfusionreactions.

    The large-bore needle allows cells to flowmore easily without occluding the lumen ofthe catheter.

    Human error is the most common cause of

    ABO incompatibility reactions.

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    Nursing ConsiderationsDuring administration

    Rationale

    1. Administer the blood product using

    the appropriate filtered tubing.

    2. If the blood product needs to bediluted, use only normal saline

    solution.

    3. Remain with the client for the first

    15 to 30 minutes of the infusion.

    4. Infuse the blood product at theprescribed rate.

    5. Monitor vital signs.

    Filters are needed to remove aggregates

    and possible contaminants.

    Hemolysis occurs if any I.V. solution isused.

    Hemolytic reactions occur more often

    within the first 50 mL of the infusion.

    Fluid overload is potential complication ofrapid infusion.

    Vital sign changes often indicate

    transfusion reactions.

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    Nursing ConsiderationsAfter transfusion

    Rationale

    1.When the transfusion is completed,

    discontinue infusion and dispose of the bagand tubing properly.

    2. Document.

    Blood borne pathogens may be spread

    Inadvertently through improper disposal.

    The client record should indicate the typeof product infused, product number,

    volume infused, time of infusion, and any

    adverse reactions.

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    THANK YOU FOR LISTENING!

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    Thank you maam for the

    you know!

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