Case Study: Blood Administration Ms. Davis who is 40 years old is found to be severely anemic d.t. a gastric bleed. She is stable but still needs to receive a transfusion of packed red blood cells because her hemoglobin is 7.1 The blood bank has just called to let you know that the blood product is ready for pick up . Answer the following questions about the procedure and nursing responsibilities.
Before administration of the packed red blood cells, the nurse should: A. Assess vital signs B. Identify the patient C. Assess that proper size intravenous access is patent D. All the above
With another RN, the nurse administering the transfusion needs to verify the blood product and the patient's identity by comparing the laboratory record sheet with: A. Patient name and ID number is checked verbally and against ID band. B. Blood unit is checked with bad and unit number on laboratory record. C. Blood group and RH type is compared with bag and laboratory record. D. Check the expiration date on blood product. E. All the above
What is the rationale for flushing the line with normal saline before administering the blood product? A. The saline prevents blood from mixing with any IV solutions that may contain dextrose. B. The saline keeps the blood from clotting. C. Hospital policy dictates this procedure. D. Flushing with saline assures patency of the infusion site.
What is the rationale for infusing the blood slowly for the first 15 minutes? A. Hospital policy dictates this procedure. B. To prevent fluid overload C. Most blood reaction occur in the first 15 minutes. D. To prevent a transfusion reaction.
Ms. Davis begins to complain of chills and headache after 10 minutes of the transfusion. her temperature is 101.2 degrees. This suggests a: A. Hemolytic reaction B. Febrile reaction C. Allergic reaction D. Septic reaction
The most appropriate action by the nurse is to: A. Call a code B. Slow the transfusion and administer oxygen C. Stop the infusion, keep vein open with saline, call physician. D. Stop the infusion and give adrenalin.
Because of your prompt intervention, Ms. Davis recovers quickly. Since she was found to have a febrile reaction, the physician orders another transfusion of a leukocyte-reduced blood product. She receives Tylenol prior to the transfusion and it is completed without incidence.
