Blood Product Administration Keith Rischer RN Erythrocytes q

Blood Product Administration Keith Rischer, RN

Erythrocytes q Function q Normal Life span q Norms ü Hgb ü – Women: 12 -16 g/dl – Men: 13. 5 -18 n g/dl HCT – Women: 38 -47% – Men: 40 -54% ü RBC – 4. 0 -5. 0 mm 3 – 4. 5 -6. 0 mm 3

Terms Ø Ø Ø Agglutinin Antigen Autologous donor ABO Rh

General Overview Ø Types of blood products q q Ø Ø PRBC FFP Platelets Albumin Indications specific to component Importance of nursing role

Nursing Assessment: Pre-Transfusion Ø IV site Site q Size q Ø Ø Verify MD order Establish baseline VS Consent signed Education q Ø Transfusion history Report chills, dizziness or fever

Safety First Ø Ø First check Double check Blood type & Rh q Patient name q MR # q Expiration date q Unit # on compatibility tag q Both document q

Nursing Responsibilities Ø NS q Ø Prime tubing before VS checks 15” q Every hour infusing q End q Ø Volume in unit Rate of administration Ø ½ hourly rate first 15” q Observe first 15” Document Ø q

Complications Ø Ø Fluid overload Lyte imbalances Hypothermia Thrombocytopenia

Transfusion Reactions Febrile Reaction q Sudden onset of chills, fever, temp elevation >1 degree C. headache, anxiety Mild Allergic Reaction q Flushing, urticaria, hives Allergic Acute Hemolytic Reaction q Chills, fever, flushing, tachycardia, SOB, hypotension, acute renal failure, shock, cardiac arrest, death

Transfusion Reaction Responsibilities Ø Ø Ø Ø STOP transfusion stat & disconnect Maintain IV site-disconnect from IV and flush with NS Recheck ID Notify blood bank/MD Monitor VS Treat sx per MD orders Save bag and tubing-send to blood bank Document per policy