Blood Transfusions
What size IV gauge is needed for rapid blood transfusions?
What is 14-16g
Why are patient's ordered continuous IV infusions for maintenance
for ex: 100ml/hr of normal saline continuous
What is to keep the fluid and electrolyte balance in the body
DOUBLE JEOPARDY: What percentage is it for older adults?
What is 50 to 60%
DJ: 45-55%
What three categories are in passive transport?
What is Diffusion, Osmosis, and Filtration
What are potassium rich foods? Name at least 4
Fresh fruit(apricots, bananas, cantaloupe, grapefruit, honeydew, melon, oranges
Dried fruit
Chicken, beef, liver, milk, nuts, peanut butter, pork, veal, turkey
green vegetables, carrots, dried beans and peas, mushrooms, potatoes, squash, tomatoes
What is done before a blood transfusion is initiated?
What is type and cross matching
What is the definition of phlebitis?
What is inflammation of the vein: can be mechanical, chemical, or bacterial irritation of the vessel
What is the difference between intracellular and extracellular? Which of the two is larger?
What is diffusion?
What is the natural tendency of a substance to move from an area of higher concentration to an area of lower concentration
What are important nursing interventions for a patient with hypokalemia? name 3
What is
administer supplements as ordered
administer kayexalate if ordered
monitor I&O
monitor labs, especially potassium and kidney function
encourage foods high in potassium
How is a blood transfusion set up?
DOUBLE JEOPARDY: What type of fluid causes blood to lyse or be destroyed?
What is Primary IV 0.9% normal saline is primed through a Y-set tubing, and the blood bag is spiked on the second part of the Y
DJ: What is Dextrose
What is the definition of infiltration?
What two areas make up extracellular fluid?
Double jeopardy: name an example of a fluid in each area
What is intravascular and interstitial fluid?
What is plasma, what is lymph (or CSF, GI secretions, urine, perspiration, exudates, intraocular fluid)
How is osmosis different than diffusion?
DOUBLE JEOPARDY: What is a medication to help with edema, that uses osmosis to help reduce the fluid retention?
What is osmosis moves water across a semipermeable membrane, from an are of lower concentration to an area of higher concentration
DJ: What is lasix
Why may someone need a central line over a peripheral line? name 3
What is bad veins, chemotherapy drugs, irrigating fluids, parenteral nutrition, frequent labs, or hemodialysis
What are the S/S of a blood transfusion reaction?
(10 things- name at least 7)
Bonus 200pts for naming all 10
What is
Chills, fever, low back pain, pruritis(itching), hypotension, nausea, vomiting, decreased urine output, chest pain, wheezing, dyspnea
What is the main difference between infiltration and phlebitis?
Phlebitis is warm, red, and tender
both have discomfort and edema
Infiltration is cool to the touch
What two systems play a role in fluid balance in the body?
A patient condition with too little or too much potassium is known as what:
What must you monitor on your patient when this occurs?
DOUBLE JEOPARDY: WHY?
What is hypo/hyperkalemia
What is heart rate and rhythm
DJ: the heart muscle is affected and can cause a deadly disturbance in cardiac function/ can also cause delays/increases in cardiac conduction
In older adult populations, they may present with SOB and wheezing after therapy is administered. What could be happening?
What is fluid volume overload
What are nursing interventions when a transfusion reaction is suspected?
DOUBLE JEOPARDY: What should be done with the bag of blood and tubing?
What is:
Stop the transfusion IMMEDIATELY
Assess your patient
Notify the provider
Review VS and PRN meds
DJ: Keep the bag and all tubing and all components to send back to the lab for review
What is the best treatment of phlebitis?
DOUBLE JEOPARDY: What are some nursing interventions for this? (there are 4, name at least 2)
What is prevention pg. 516
What is rotating IV sites every 72 hours
use smallest IV gauge possible
Use CVC or PICC for long term therapy
use bigger veins for hypertonic solutions
How do the kidneys aid in fluid balance?
Double Jeopardy: How many ml/hr of urine must the kidneys excrete to effectively eliminate waste from the body?
What us GFR / DJ 30
What are causes of hypocalcemia? There are 19, name at least 4
What is: alkalosis, anticonvulsants, chronic RENAL FAILURE, DEFICIENCY in calcium or vitamin D, disease of small bowel/malabsorption, DIURETICS, excess alcohol intake, draining intestinal fistulas, excess binding of Ca ions, increased magnesium, SEVERE BURNS, pancreatic disease, severe diarrhea, thyroid surgery
Hypernatremia causes edema, how?
DOUBLE JEOPARDY: What are s/s of hypernatremia? name 4 (not edema mentioned above)
What is hypernatremia causes fluid to shift from the cells to the interstitial spaces, which results in cellular dehydration and interruption in cellular processes
DJ: dry mucus membranes with thick mucus, firm rubbery tissue turgor, low UO, restlessness, agitation, confusion, flushed skin