Revalida 1

Revalida
-Considerations prior to blood transfusion
Nursing Interventions
1. Verify doctor’s order. Inform the client and explain the purpose of the
procedure.
2. Check for cross matching and typing. To ensure compatibility
3. Obtain and record baseline vital signs
4. Practice strict asepsis
5. At least 2 licensed nurse check the label of the blood transfusion. Check
the following:
 Serial number
 Blood component
 Blood type
 Rh factor
 Expiration date
 Screening test (VDRL, HBsAg, malarial smear) – this is to ensure that the
blood is free from blood-carried diseases and therefore, safe from
transfusion.
6. Warm blood at room temperature before transfusion to prevent chills.
7. Identify client properly. Two Nurses check the client’s identification.
8. Use needle gauge 18 to 19 to allow easy flow of blood.
9. Use BT set with special micron mesh filter to prevent administration of
blood clots and particles.
10.Start infusion slowly at 10 gtts/min. Remain at bedside for 15 to 30
minutes. Adverse reaction usually occurs during the first 15 to 20 minutes.
11.Monitor vital signs. Altered vital signs indicate adverse reaction (increase in
temp, increase in respiratory rate)
12.Do not mix medications with blood transfusion to prevent adverse effects.
Do not incorporate medication into the blood transfusion. Do not use
blood transfusion lines for IV push of medication.
13.Administer 0.9% NaCl before; during or after BT. Never administer IV
fluids with dextrose. Dextrose based IV fluids cause hemolysis.
14.Administer BT for 4 hours (whole blood, packed RBC). For plasma, platelets,
cryoprecipitate, transfuse quickly (20 minutes) clotting factor can easily be
destroyed.
15.Observe for potential complications. Notify physician.
-Who are likely to receive BT?
- You may receive a blood transfusion if you lose a large amount of blood due to surgery or injury or if
you have a bleeding disorder. The transfusion may be needed to replace red blood cells, white blood
cells, blood plasma or platelets. Red blood cells are the most commonly transfused blood part.
- indicated for the client who has hypovolemia secondary to hemorrhage, anemia or another disease
process that is associated with a deficiency in terms the client's clotting or another component of blood,
for example. Although hypovolemia can be treated with fluid replacement, this fluid does not provide
the client with the oxygen carrying components that only blood has. In addition to blood's components
in terms of oxygen transporting red blood cells, blood also transports carbon dioxide, and it contains
white blood cells to combat infection, clotting factors and essential blood proteins.
-What is KVO?
A term used in a hospital that indicates the need for a continuous intravenous infusion (usually using
normal saline solution). Purpose: To allow immediate access if intravenous medication is required for
emergency or other treatment purposes.
An order indicating that the patency of an intubated vessel be maintained so that subsequent intraveno
us solutions or medicines can be administered. This is done using the lowest possible infusion rate with
a microdrop set or a volume controller.
-What is the purpose of KVO?
-What are the untoward effects of BT/ complications?
Allergic Reactions
Some people have allergic reactions to blood received during a transfusion, even when given the right
blood type. In these cases symptoms include hives and itching. Like most allergic reactions, this can be
treated with antihistamines. However, a doctor should be consulted if the reaction becomes serious.
Fever
Developing a fever after a transfusion is not serious. A fever is your body’s response to the white blood
cells in the transfused blood. However, it can be a sign of a serious reaction if the patient is also
experiencing nausea or chest pain. Patients should consult their doctors if other symptoms or side
effects are present.
Acute Immune Hemolytic Reaction
An acute immune hemolytic reaction is a very serious, but rare, reaction caused by a patient’s body
attacking the transfused red blood cells. The attack triggers a release of a substance that damages the
kidneys. This is often the case when the donor blood is not a proper match with the patient’s blood type.
Symptoms include nausea, fever, chills, chest and lower back pain, and dark urine.
Blood-borne Infections
All donated blood is screened and tested for potential viruses, bacteria, and parasites. However,
occasionally these agents can still infect a patient after a transfusion.
The risk of catching a virus or any other blood-borne infection from a blood transfusion is very low.
 HIV. All donated blood is thoroughly tested for HIV. There is a 1 in 2 million chance that donated
blood will not only carry HIV but also infect a transfusion recipient.
 Hepatitis B and C. The odds of catching hepatitis B from donated blood is about 1 in 300,000.
The risk with hepatitis C is 1 in 1.5 million.
 West Nile Virus. The risk of catching West Nile Virus from a blood transfusion is approximately 1
in 350,000.
Sepsis
Sepsis is characterized with fever, hypotension, oliguria, chilling, nausea and vomiting This transfusion
reaction occurs as the result of some contaminate in the blood. This complication is treated with
intravenous fluids and antibiotics. The intravenous tubing, the blood filter, the blood bag with its
remaining contents are retained and sent to the laboratory. A sample of the client's blood and urine are
also taken and sent for diagnostic testing as is also done when the client has a hemolytic reaction.
-Initial drops per minute of BT and time
How many drops per minute should blood transfusion?
Calculating the duration of an infusion
To solve this, we first need to find out how many millilitres are transfused per minute, we do this as
follows: The drop rate is 42 drops per minute. The drop factor is 20 drops per ml.
Transfusion should be completed within 4 hours of leaving controlled temperature storage
-Why? The drop rate is 42 drops per minute. The drop factor is 20 drops per ml. If we divide 42 drops
per minute by 20 drops per millilitre, we'll find out how many millilitres per minute. 42/20 = 2.1 ml per
minute.
Rate – approximately 2 mL/minute (120mL/hour) for 1st 15 minutes, then increase rate to infuse over
1 to 2 hours (150-250 mL/hr), or as ordered. Do NOT hang longer than 4 hours.
Objectives
1. To increase circulating blood volume after surgery, trauma, or hemorrhage
2. To increase the number of RBCs and to maintain hemoglobin levels in clients with severe anemia
3. To provide selected cellular components as replacements therapy (e.g. clotting factors, platelets,
albumin)

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Revalida

-Considerations prior to blood transfusion

-Who are likely to receive BT?

-What is the purpose of KVO?

-What are the untoward effects of BT/ complications?

Acute Immune Hemolytic Reaction

-Initial drops per minute of BT and time

How many drops per minute should blood transfusion?

Calculating the duration of an infusion

Transfusion should be completed within 4 hours of leaving controlled temperature storage

1. To increase circulating blood volume after surgery, trauma, or hemorrhage

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