Questions Options Minnie, Jane’s nurse, is going to draw blood samples for testing, including a group & screen. Best practice is: Ask Jane’s mother her daughter’s surname, first name, date of
Questions Options
Minnie, Jane’s nurse, is going to draw blood samples for testing, including a group & screen. Best practice is:
Ask Jane’s mother her daughter’s surname, first name, date of birth, collect the blood samples, immediately place the labels on the blood tubes, document she collected the blood and send the samples to the Lab.
Confirm Jane’s surname, first name and unique identification number on her armband are identical to that on the sample label, collect the blood samples, immediately place the labels on the blood tubes, document she collected the blood and send the samples to the Lab.
Confirm Jane’s surname, first name and hospital identification number on her armband are identical to that on the sample label, collect the blood samples, put the blood tubes in her pocket while she goes to the desk to speak with Radiology, after the telephone discussion place the labels on the blood tubes, document she collected the blood and send the samples to the Lab.
Collect the blood samples, immediately place the labels on the blood tubes, document she collected the blood, confirm Jane’s surname, first name and hospital identification number on her armband are identical to that on the label on the blood tubes, and send the samples to the Lab.
Ira Doodle is a 75 year old man admitted to Oncology for relapsed leukemia. Chemotherapy has been initiated. His Hb is 60 g/L and his platelet count is 6 x 109. He is short of breath but has not required oxygen. His physician has ordered 1 unit of RBC to be transfused over 2 hours followed by 1 dose of platelets to be transfused over 60 minutes. Mario, Ira’s nurse, finds a consent for transfusion form on his chart but it has not been completed. Mario’s next steps include:
Call the prescriber to discuss transfusion with Ira to complete the consent process and the form
Administer the transfusion. The consent can be completed tomorrow when the prescriber reassesses Ira
Administer the transfusion. Ira states he has had several transfusions three years ago when diagnosed with leukemia, has no questions or concerns about transfusion and is sure he signed a consent form then
Administer the platelet transfusion first and call the prescriber. Consent is required only for RBC transfusion
The compatible IV solution for blood component transfusion is:
Ringer’s Lactate
5 % Dextrose in water
0.9 % sodium chloride
0.9 % sodium chloride with 20 milliequivalent (mEq) potassium chloride per litre
Florence Brocade is a 72 year old female post-operative day 3 following revision hip joint replacement surgery. The physiotherapist reports Florence experienced syncopal episodes when attempting to mobilize. Florence’s Hb is 68 g/L this morning. Her prescriber orders 2 units RBC to be transfused, each unit over 2 hours. Florence’s nurse Minnie should discuss with the prescriber to consider:
Canceling the 2 unit RBC transfusion and initiating PO iron
Decreasing the RBC transfusion to 1 unit and re-assess Florence’s clinical status and Hb post-transfusion to determine if additional transfusion is needed
Increasing the RBC transfusion to 3 units to target a post-transfusion Hb close to 100 g/L
Infusing 500 mL of 0.9 % sodium chloride in addition to the 2 units RBC
Jane’s blood group is AB, Rh(D) positive, antibody screen negative. This indicates the antigen(s) present on Jane’s red blood cells are:
None
A, B, D
A, B
D
When checking the RBC unit for Florence prior to transfusion, Minnie should ensure:
Florence is wearing a patient identification armband and the checking steps are carried out at Florence’s bedside
The ABO and Rh(D) blood groups of the RBC unit to be transfused is identical to Florence’s ABO and Rh(D) blood groups
The RBC unit numbers printed on CBS label, on the transfusion label and the chart label/issue form are in chronological sequence
Florence’s date of birth is correct and identical on patient identification armband, on the prescriber’s order, the transfusion label and the chart label/issue form
Jane’s blood group is AB Rh(D) positive, antibody screen negative. This indicates the antibody(ies) present in Jane’s plasma are:
None
Anti-A, anti-B, anti-D
Anti-A, anti-B
Anti-D
The rationale for plasma transfusion is:
Transport oxygen from the lungs to the tissue cells
Act as the first responders in the clotting process to stop bleeding (sticky cells)
Provide all the coagulation factors necessary for the clotting process to stop bleeding
Decrease the workload of the heart and lungs
For Jane (a 25 year old female), the transfusion special requirement is:
Irradiated RBC
Irradiated platelet
K negative RBC
No special requirements are indicated for Jane
Hemolysis of red blood cells can occur if:
Blood is administered with an incompatible IV fluid
RBC unit is transfused through a small gauge IV
Incompatible blood is transfused
All are correct
Risk factors for Transfusion Associated Circulatory Overload (TACO) include:
Receiving both RBC and platelet transfusions within a 24 hour period
Diagnosis of relapsed leukemia and receiving chemotherapy
Advanced age, history of heart failure or myocardial infarction, left ventricular dysfunction, renal dysfunction, positive fluid balance
Male gender with diagnosis of liver disease
The rationale for platelet transfusion is:
Transport oxygen from the lungs to the tissue cells
Act as the first responders in the clotting process to stop bleeding (sticky cells)
Provide all the coagulation factors necessary for the clotting process to stop bleeding
Decrease the workload of the heart and lungs
Patients receiving blood components should be closely monitored. As recommended, at minimum, Minnie should assess Florence’s clinical status and vital signs:
Within 30 minutes prior to starting transfusion, 15 minutes after starting transfusion, at completion of transfusion, periodically for up to 24 hours post transfusion, and if a transfusion reaction is suspected
Periodically prior to starting transfusion, 15 minutes after starting transfusion, at completion of transfusion, within 30 minutes post transfusion, and if a transfusion reaction is suspected
Within 15 minutes prior to starting transfusion, 15 minutes after starting transfusion, at completion of transfusion, periodically for up to 24 hours post transfusion, and if a transfusion reaction is suspected
Within 30 minutes prior to starting transfusion, 30 minutes after starting transfusion, at completion of transfusion, within 30 minutes post transfusion, and if a transfusion reaction is suspected
The IV tubing (blood administration set) for blood component transfusion:
Includes a 170 to 260 micron filter to capture any fibrin debris
Platelets should be transfused through new/fresh blood tubing/filter
Can be primed with 0.9 % sodium chloride or the blood component
All are correct
Minnie picked up Florence’s RBC at 1300 hours from TML. Florence was called to Radiology for x-rays of her hip, so Minnie kept the RBC unit on the medication cart. Minnie started the RBC transfusion at 1430 hours when Florence returned from Radiology. At 1700 hours Minnie realized she did not program the infusion pump rate correctly and only 50 mL of the RBC unit had been transfused. Minnie’s next step is:
Re-start the entire transfusion, infuse at 50 mL/hour for 15 minutes, re-assess the patient, if no concerns, increase the rate to infuse the RBC unit over 2 hours
Discard this RBC unit. Notify the prescriber. If prescriber orders, call TML to issue another RBC unit
Increase the rate of infusion to 150 mL/hour to transfuse the majority of the unit over 2 hours as originally ordered
Increase the rate of infusion to 500 mL/hour to complete the transfusion as quickly as possible
Mario notes Ira is elderly, already short of breath, had a heart attack 2 years ago and was admitted with congestive heart failure 3 months ago. Mario’s best practice next action:
Administer the RBC and platelet transfusions as ordered. Ira’s past transfusions were uneventful.
Administer the RBC transfusion as ordered over 2 hours and re-assess. If Ira tolerates the RBC transfusion, it is likely he will also tolerate the platelet transfusion.
Call the prescriber to review Ira’s risk factors for TACO and consider slower infusion rates for the transfusions and pre-transfusion diuretic.
Call the prescriber to review delaying transfusion until Ira’s shortness of breath improves.
When possible (stable patient), RBC transfusion should be initiated at a slow infusion rate for the first 15 minutes. As recommended, Minnie should initiate Florence’s RBC transfusion at:
150 mL/hour
100 mL/hour
50 mL/hour
15 mL/hour
Jane Dough, a 25 year old female unstable, bleeding, multiple trauma patient has just arrived in Emergency. The physician orders stat RBC and plasma transfusions. TML will issue:
Group O Rh(D) positive RBC and group O plasma
Group O Rh(D) negative RBC and group O plasma
Group O Rh(D) positive RBC and group AB plasma
Group O Rh(D) negative RBC and group AB plasma
At 2015 hours Mario, Florence’s nurse for 1900 to 0700 hours shift, completed the RBC transfusion Minnie had initiated at 1800 hours. Minnie had documented the transfusion start time. For transfusion, Mario is required to document:
Florence’s urine output
The hospital room number where the transfusion was administered
The clinical assessments and vital signs he completed, the volume transfused, and the transfusion stop time
Florence’s weight post-transfusion
About 20 minutes after the start of the platelet transfusion, Ira complained of feeling chills. Mario’s actions include:
Stop the transfusion for 15 minutes, re-start it and monitor Ira closely
Increase the rate of infusion to complete the transfusion as quickly as possible
Stop the transfusion and discard the remainder of the platelets
Stop the transfusion, maintain IV access, check vital signs, verify patient armband identification matches transfusion label and notify prescriber
Collepals.com Plagiarism Free Papers
Are you looking for custom essay writing service or even dissertation writing services? Just request for our write my paper service, and we'll match you with the best essay writer in your subject! With an exceptional team of professional academic experts in a wide range of subjects, we can guarantee you an unrivaled quality of custom-written papers.
Get ZERO PLAGIARISM, HUMAN WRITTEN ESSAYS
Why Hire Collepals.com writers to do your paper?
Quality- We are experienced and have access to ample research materials.
We write plagiarism Free Content
Confidential- We never share or sell your personal information to third parties.
Support-Chat with us today! We are always waiting to answer all your questions.
