N105: Essentials of Nursing Care - Health Differences

Essentials of Nursing Study Guide

©2017 Achieve Test Prep Page 74 of 160 are used to replace platelets in clients with bleeding disorders or platelet deficiency. Fresh platelets are the most effective. Fresh frozen plasma expands blood volume and provides clotting factors; it does not need to be typed/cross matched. Albumin and plasma prot in fraction expands blood volume and provides plasma proteins. Clotting factors and cryoprecipitate are used for clients with clotting factor deficiencies. Each provides different factors involved in the clotting pathway; cryoprecipitate also contains fibrinogen. Transfusion Reactions • Hemolytic reaction : symptoms include chills, fever, headache, backache, dyspnea, cyanosis, chest pain, tachycardia, and hypotension • Febrile reaction : symptoms include fever, chills, warm flushed skin, headache, anxiety, and muscle pain • Allergic reaction (mild): symptoms include flushing, itching, urticaria, and bronchial wheezing • Allergic reaction (severe): symptoms include dyspnea, chest pain, circulatory collapse, and cardiac arrest • Circulatory overload : symptoms include cough, dyspnea, crackles (rales), distended neck veins, tachycardia, and hypertension • Sepsis : symptoms include high fever, chills, vomiting, diarrhea, and hypotension Administering blood is one of the riskiest procedures that a nurse performs because of the potential for lethal reactions. Keep the following precautions in mind: • Identify the patient, identify the blood product, and perform assessment on the patient prior to and after the procedure • Consent for blood prior to sending for the blood • Obtain blood from blood bank just before starting transfusion (less than 30 minutes); do not store blood • Blood is administered through an 18-19g needle • ‘Y’ set with an in-line or add-on filter with an IV of normal saline • Transfusion should be completed within 4 hours of initiation • Change tubing with each unit transfused disorders with slow bleeding. One unit raises hematocrit by 4%. Autologous red blood cells are used for blood replacement following planned elective surgery. The client donates blood for autologous transfusion 4-5 weeks before the elective surgery. Platelets