8.3: Chapter 3

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May 19, 2024
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- 8.2: Chapter 2
- 8.4: Chapter 4

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Case Study #1

1. Indications for a blood transfusion for Helen:

Anemia (Hgb of 6.5 g/dL)
Fatigue and exhaustion
Pale appearance

2) Considerations for starting an IV for the blood transfusion:

Client assessment: Check Helen’s vital signs, hydration status, and any underlying medical conditions.
Site selection: Choose the best IV site, taking into consideration the age of the client, access, and current skin condition. Consider the size of catheter, optimally a 20-gauge catheter or larger for blood administration.
Equipment and supplies: Ensure you have all necessary equipment, such as an IV catheter, blood tubing, sterile dressing, and saline.
Safety measures: Follow standard infection control procedures to prevent transmission of infectious diseases.
Client comfort: Explain the procedure to Helen.

3) Steps to prepare for the administration of blood for Helen:

Ensure Helen has signed the consent for blood transfusion
Verify the correct patient with 2 identifiers, blood type, and cross-match
Check the compatibility of the blood with the client’s blood type and cross-match
Check for any allergies or sensitivities to components of the blood
Ensure that the blood is labeled

4) Precautions or nursing considerations:

Monitor for adverse reactions, such as fever, chills, itching, or hives
Observe for signs of anaphylaxis
Check the IV site regularly for any signs of infiltration or infection
Monitor vital signs and fluid status
Monitor for signs of fluid volume overload; administer transfusion at an appropriate rate to not overload the client

5) Assessments to be completed prior to the blood transfusion:

Vital signs
Lung sounds
Allergies or sensitivities to components of the blood
Blood type and cross-match

Assessments to be completed during the blood transfusion:

Vital signs
Lung sounds
Fluid status
IV site
Any adverse reactions

6) Blood type O- is compatible with O- and O+ blood types.

7) Steps to ensure safety for the client during blood transfusion:

Verify the correct client and blood type
Check the compatibility of the blood with the clent
Check for any allergies or sensitivities to components of the blood
Monitor vital signs, lung sounds, and fluid status
Observe for signs of adverse reactions

8) Steps for the procedure of administering the blood transfusion:

Administer furosemide 20 mg IV as ordered
Complete checks with a second RN
Attach the transfusion set to the IV tubing
Begin the transfusion at a slow rate and monitor vital signs
Observe the client for adverse reactions and adjust the rate as needed
Document the transfusion, including the amount and rate of transfusion, any adverse reactions, and any changes in the client’s condition
Administer furosemide 20 mg IV between units
Administer second unit of PRBCs
Discontinue the transfusion and remove the IV catheter once the transfusion is complete

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