Learning about Blood Transfusions
This was probably one of the skills in nursing school I loved to learn about and when I was in a clinical setting and able to do my first blood transfusion with the nurse on a patient I was so excited! Understanding all the types of blood that can be transfused, the process behind giving the transfusion, and monitoring the patient through and after the transfusion is very important. Here, you will learn everything you need to know to give blood to a patient and be safe.
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Blood Transfusions Overview
1. Four types of products→ Packed Red Blood Cells (PRBCs), cryoprecipitate, fresh frozen plasma, and platelets
2. Must match donor type→ ABO type, Rh status, and special antibodies
General Information on Blood Transfusions
1. PRBCs aka “Unit of Blood” → Given for anemia2. FFP (Fresh Frozen Plasma)
a. Contains clotting factors
3. Platelets
a. Given for thrombocytopenia and often pre-procedure for clients with Platelets <50. Re-check 1-hour post-transfusion.
4. Cryoprecipitate
a. Contains fibrinogen and is commonly used for hemorrhage and disseminated Intravascular Coagulation (DIC)
5. Prepare to transfuse
a. Type and crossmatch/screen
b. Pre-transfusion vitals
c. Administration materials
i. The special blood IV tubing
ii. 0.9% normal saline
iii. Access to emergency medications
6. Begin transfusion
a. Independent double-check completed by two RNs
b. Initiate infusion at a slow rate for the first 10-15 minutes
c. Monitor for Reaction
7. Transfusion Reactions
a. Present similarly to anaphylaxis and can occur up to 24 hours after transfusion
8. Delayed Transfusion Reactions
a. Caused by antibody mismatch and can be potentially fatal
Nursing Assessment for Blood Transfusions
1. Transfusion reactions most commonly occur in the first 10-15 minutes, and symptoms are pruritus, rash, fever, chills, low back pain, and anxiety2. Delayed transfusion reactions occur in clients who have received transfusions before, or if there are undetectable antibodies below the threshold of screening
3. Post-Transfusion→ Redraw Complete Blood Count (CBC)
Therapeutic Management for Blood Transfusions
1. Transfusion Reactions
a. Immediately STOP transfusion, SAVE the blood product for lab
b. Treatment similar to anaphylaxis
i. Notify provider
ii. Anti-histamines (diphenhydramine)
iii. Acetaminophen
iv. Consider furosemide for fluid overload and to maintain kidney function
c. Monitor airway patency
d. Maintain IV access
e. Report to the blood bank
Nursing Case Study for Blood Transfusions
Patient Profile:
- Name: Robert Mick
- Age: 68 years old
- Gender: Male
- Medical History: coronary artery disease, anemia
- Fatigue and weakness
- Pallor
- Shortness of breath
- Low hemoglobin and hematocrit levels
- Physical Examination: Mr. Mick displayed signs of anemia, including pallor and fatigue
- Laboratory Tests: Confirmed low hemoglobin and hematocrit levels, indicating the need for a blood transfusion.
Mr. Mick had a history of coronary artery disease and chronic anemia
Mr. Mick was diagnosed with severe anemia and required a blood transfusion to improve his oxygen-carrying capacity
Treatment Plan:
- Blood Type and Crossmatch:
- Determined Mr. Mick’s blood type and crossmatched compatible blood units
- Informed Consent:
- Obtained informed consent from Mr. Mick before initiating the blood transfusion
- Transfusion Process:
- Monitored vital signs and assessed for signs of transfusion reactions during the procedure
- Post-Transfusion Care:
- Monitored Mr. Mick for any adverse reactions and ensured adequate post-transfusion recovery
Outcome:
With diligent nursing care and the successful blood transfusion, Mr. Mick’s hemoglobin and hematocrit levels improved, alleviating his anemia symptoms. He reported feeling less fatigued and was able to breathe more comfortably.
Conclusion and Free Download
This blood transfusion review provides essential knowledge for approaching the NCLEX with confidence. Understanding its prevention, management, and interventions empowers nurses to provide effective care and save lives.
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Happy Nursing!
