NUR Exam 1: Blood Transfusions and Central lines- latest updates

Blood Transfusions & Central Lines What does “type & cross­match for 2 U PRBC” mean? ­ “Type”: Determining a person’s blood type ­ “Cross Match”: Determining compatibility between blood specimens ­ PRBC= spin the blood down & remove plasma ** Look at lecture notes page 2—Most common types of blood & compatibility chart** ­ AB+ = universal recipient ­ O­= universal donor Pre­transfusion responsibilities ­ Assess lab values (latest H&H) ­ Verify order ­ Confirm type and cross matching has been done in last 48 hours ­ Positive identification of patient; consent form ­ Pre­medicate as ordered ­ Iv setup: o Venous access (20 ga or larger) o Y tubing (one for blood, one for NS) o Filter o NS only ­­NO D5/LR ­ Be ready before blood gets to floor (only have 30 min) Y tubing: ­ Both roller clamps off ­ Open bag of NS ­ Prime tubing ­ Hook to saline lock and check patency ­ Turn off saline ­ Spike PRBC ­ Hang blood & open roller clamp ­ Prime ­ Document The final patient identity check should be done at the bedside ! Transfusion Responsibilities ­ If blood not used right away­ return to blood bank ­ Explain procedure/patient needs to report unusual sensations immediately o Chills, SOB, itching, back pain ­ Take baseline vital signs ­ Begin infusion slowly ­ Constant observation by RN first 15­30 minutes (per protocol) ­ Assess VS in 15 minutes o If no reaction­ increase rate to infuse in about 2 hours (unless risk of FVE) ­ Take VS every hour and at end of transfusion ­ 4 hours maximum (decrease risk for bacterial proliferation) ­ Post infusion orders? o Lasix – pulls extra fluid out o Another unit?? What else might a nurse be asked to transfuse? ­ PRBC ­ Platelets ­ FFP (fresh frozen plasma) ­ Albumin