Blood Transfusions
Cellulitis
¡Mystery!
UTIs
100
This blood type is considered a universal donor.
What is O-?
What type of blood can patient's with type O- receive?
100
These are at least four signs/symptoms of cellulitis.
What are:
- Erythema
- Edema
- Pain
- Fever
- Warmth
- Draining/weeping
What can increase the risk of developing cellulitis?
100
These are elements of a urinalysis that would be found when a UTI is present.
What are malodorous, cloudy, increased specific gravity, pH (alkaline), WBC, nitrites, blood, leukocytes esterase, and casts?
100
This calculated renal lab naturally decreases with age.
What is glomerular filtration rate (GFR)?
Other renal changes related to aging include nocturia, decreased bladder capacity, weakened urinary sphincters and shortened urethra in women, and tendency to retain urine.
200
Prior to a blood transfusion, these are at least three appropriate interventions/actions to take.
What are:
- Draw labs for ABO typing/Rh factor
- Baseline vital signs (prior to requesting from blood bank)
- Ask about h/o transfusions/reactions
- Gather equipment
- Check for blood transfusion consent
- Administer with at least one other licensed individual
When are vital signs taken during a blood transfusion?
200
These the appropriate isolation precautions when caring for a patient with MRSA.
What are contact precautions (gown, gloves, hand hygiene)?
200
This is the time for vancomycin IV administration.
What is at least 60min or 10mg/min?
IV must be given as a slow IV infusion (IV piggy bag or secondary). Vein and PIV catheter patency must be verified and maintained, as vancomycin is damaging to the tissue if extravasated.
200
These are at least three factors that increase risk of developing a UTI.
What are:
- Obstruction (incomplete bladder emptying)
- Stones (irritation and obstruction)
- Urine pH (can promote bacterial growth)
- Females (shorter urethra, more susceptible during menopause when estrogen decreases, use of internal feminine products or bladder displacement)
- Males (prostate enlargement, STI)
- Age urinary stasis caused by incomplete bladder emptying, incontinence, decreased immunity)
- Recent use of antibiotics change the normal protective flora providing opportunity for bacterial growth?
300
After receiving blood products from the blood bank, they must be started within 1)_____this amount of time and completed within 2)____this amount of time.
What is 20-30min and 4 hours?
When does blood transfusion IV tubing expire?
300
These are labs monitored to assess kidney function.
What are creatinine (Cr), blood urea nitrogen (BUN), and BUN/Cr ratio?
BUN test measures the amount of nitrogen in the blood that comes from the waste product urea. Urea is made when protein is broken down in the body. Urea is made in the liver and eliminated in the urine. BUN test is done to see how well kidneys are working.
Creatinine - Creatinine is a chemical compound left over from muscle metabolism. Healthy kidneys filter creatinine out of the blood. Creatinine exits the body as a waste product in urine. Creatinine test monitors kidney function.
BUN/Cr ratio - A high BUN/Creatinine ratio indicates an underlying disease/disorder. BUN levels fluctuate, while creatinine is removed at a constant rate and its blood levels are usually stable. That’s why the BUN/Creatinine ratio can be used to check for issues such as dehydration, kidney injury/disease, gut bleeding, and other problems.
300
A patient with this blood type is considered a universal recipient for blood transfusions.
What is AB+?
300
This is the leading cause of urosepsis.
What are CAUTIs?
Catheter-associated urinary tract infections.
400
Urticaria, itching, bronchospasm or anaphylaxis are signs of this type of blood transfusion reaction.
What is allergic reaction?
400
These are at least two indications for administration of vancomycin.
What are:
- IV: treatment of serious or severe infections caused by susceptible strains of methicillin-resistant (beta-lactam-resistant) staphylococci, septicemia, infective endocarditis, and skin infections?
- PO: treatment of Clostridium difficile-associated diarrhea and enterocolitis?
400
Vancomycin needs to be infused slowly to prevent this complication.
What is red man syndrome?
This is a transfusion reaction NOT an allergic reaction.
400
These are at least three interventions to prevent CAUTIs.
What are:
- Good hand hygiene
- Insert for appropriate indications
- Remove ASAP
- Aseptic/sterile technique to insert
- Obtain urine samples aseptically
- Maintain an unobstructed flow (no dependent loops, no bags on floors, empty regularly, bag below the level of the bladder)
- Secure to thigh
- Use appropriate alternatives like condom cath and pure wick, intermittent cath for postoperative urinary retention
- Use the bladder scan to reduce the unnecessary catheterization
500
If a patient develops a suspected blood transfusion reaction, these are at least three correct actions/interventions to take.
What are:
- Stop blood transfusion
- Maintain IV access
- Prepare to send tubing to blood bank
- Start NS infusion (unless reaction is circulatory overload)
- Follow facility policy
- Notify MD and blood bank
- Administer medications as appropriate: antihistamine, acetaminophen, fluids, possibly epinephrine
500
During vancomycin therapy, these are at least three things that the nurse should monitor.
What are:
- Vancomycin level (when should a trough be drawn)
- Kidney function
- IV site monitoring for phlebitis
- Monitoring for allergic reaction
- Hydration status
- Avoiding other nephrotoxic/ototoxic drugs (i.e. NSAIDS)
Hearing assessment?
500
Hypertension, bounding pulse, JVD, dyspnea, restlessness, and confusion are signs and symptoms of this type of transfusion reaction.
What is transfusion associated circulatory overload (TACO)?
500
These are labs monitored for patient suspected of having urosepsis.
What are:
- CBC (WBC/Neutrophils)
- Blood cultures (before antibiotics)
- Urinalysis
- Urine C&S
- CRP
- Lactate; lactate is considered a sensitive marker for septic shock
- Procalcitonin (biomarkers for host response mechanisms)