NMC Policy
Administering blood at NMC requires a 2-nurse verification. True of False.
True
True! Remember to bring a patient label!
False! Not all reactions are severe enough to warrant disconnecting the infusion.
A PIV infusing a blood product should not be used for other medications while infusing. True or false.
True
Platelets are routinely stocked in NMCs blood bank. True or false.
False.
An anaphylactic reaction will most often occur one hour after the transfusion has been initiated. True or false.
False! 5-15 minutes- this is why we stay with the patient.
List the cadence of vital sign requirements for transfusion.
Pre transfusion, Q15X2, hourly, post transfusion.
What blood types (ABO) are acceptable for transfusion in a patient with type AB blood?
A, B, O
If the patient begins to have an allergic (non-anaphylactic) reaction - such as mild itching, what nursing interventions should be taken?
If mild itching develops, slow transfusion rate and monitor vital signs at least every 15 minutes. Notify the provider and administer an antihistamine, as ordered, if not already done. If the reaction subsides, continue transfusion at a rate necessary to complete transfusion within 4 hours.
In what scenario would the requirement for a signed consent and education form be waived?
Emergent transfusions. If patient cannot sign - an attempt should be made to contact family.
Cryoprecipitate is rarely used at NMC. What is it and what would we use it for?
Cryoprecipitate is essentially a concentrate of plasma- it is rich in coagulation factors, specifically fibrinogen. Cryo is indicated in hemorrhage- specific to PCU, a post tPA bleed!
A change in temperature of __ degrees from baseline is considered a febrile non-hemolytic reaction.
2 degrees.
How many hours after transfusion should the patient be monitored for transfusion reactions?
4-6 hours.
Which blood product (PRBC, FFP, platelets, cryoprecipitate) is commonly linked to TRALI?
FFP! This is due to the presence of white blood cell antibodies in plasma.
For all serious blood transfusion reactions (acute hemolytic, septic, TACO, and TRALI)- what is the first nursing intervention when a reaction is suspected?
Stop the infusion. Notify the provider. Immediately prime a second administration set with 0.9% normal saline and attach it closest to the IV insertion site and infuse to keep the vein open. Reconfirm patient identity and compare labels of all transfusion containers with blood bank records to verify correct transfusion was provided to correct patient. Continue to monitor and provide supportive measures.