Magic Numbers
Number of RNs required to check blood
2
Name the supplies necessary for administering blood
Y tubing, blood product, Normal Saline, alcohol swabs, tape, clean gloves, fresh vital signs, consent)
Visually inspect blood for___
Clots, Sediment, and Bubbles
Immediate RN response if a transfusion reaction is expected
stop blood immediately, run 0.9 NS in new tubing),
During the first 15 minutes of your patient’s blood transfusion, she suddenly has hives, SOB, and tachycardia What complication do you suspect?
Allergic Infusion Reaction
The length of time the RN should stay with the patient after starting blood.
15 minutes
When administering blood, this substance should be primed first
0.9% Normal Saline
Document that must be completed prior to administering blood
Blood Consent
Nursing assessment completed prior to blood administration
assess patency of line, site, and vital signs)
An hour after a blood transfusion, your patient reports shortness of breath. Their O2 sats are in the 80s, with crackles and ronchi. You notice a new onset of swelling in their extremities. What complication do you suspect?
Circulatory overload
The maximum amount of time a unit of blood may run after it is spiked
4 hours
When priming Normal Saline, the y clamp should remain__.
Closed
These labs should be completed prior to administering blood
Type and screen, Hemoglobin and hematocrit
Wrong blood type or product is noted during the 2 RN check
hold blood, notify blood bank
Within the first 15 minutes of a blood transfusion, the patient starts experiencing chills. You check her temperature and it reads 101.3. What complication do you suspect?
Febrile infusion reaction
Initial transfusion rate for blood products
1-2 ml/min, (60 ml/hr) or 10-20 gtts/min)
(rate to 75, volume to be infused=300)
Gauge of IV needed to administer blood products
18-20 guage
A bedside RN check of blood should include the following___
patient name and DOB, ABO and Rh type, expiration date, unit unique ID, and blood unit ID #)
When assessing patency of a line, the line does not yield blood return
No flush, blood return, occluded, swelling, patient complain of burning, or pain remove the IV
Within the first 15 minutes of a blood transfusion, the patient develops flank pain, chest pain, tachycardia and hypotension. You also note red/dark urine in her foley catheter. What complication do you suspect?
Hemolytic Reaction