blood admin

• Transfusion therapy


  Injection/administration of blood or blood products
• Blood products


  • RBC - 2-4hrs
  • Fresh frozen plasma - 15-30 mins max 2 hours
  • Platelets - 15-30 mins infusion
• Types of blood


  • Type A
  • Type B
  • Type AB
  • Type O
• Rh factor (antigen)


  (+) Rh factors means they have Rh factors on RBC

  (-) Rh factor means they don't have Rh factors on RBC
• Blood typing


  Blood test that determines blood type
• Cross-matching


  Blood test that indicated compatibility between blood of donor and recipient
• Protocols and Nursing care


  1. IV catheter size - 18–20 gauge IV line

  2. Patency before requesting blood

  3. Sterile technique

  4. NSS/Y tube IV tubing set up

  5. Baseline Vital signs

  6. Check orders

  7. Double check patient ID and blood product ID data with another licensed RN/MD

  8. Administer blood as soon as it arrives - infuse within 4 hrs

  9. Minimal handling of bag - no squeezing - potassium breakdown

  10. Vital signs - 15 min into infusion, stay with patient for first 15 min

  11. Administer very slowly 15 mins
• Saline only compatible with blood
• Flush before and after a medication if using the same line
• Post transfusion


  1. Vital signs

  2. Document findings

  3. Any adverse reaction forms

  4. Monitor lab values of what blood product was given to make sure it is therapeutic
• Transfusion reaction


  Back pain, chills
• Actions for transfusion reaction

  1. Stop the Transfusion immediately and switch it to NS

  2. Monitor vital signs and urine output

  3. Notify MD

  4. Emergency equipment
• Acute hemolytic reaction


  • Most dangerous/rapid response

  Infusion of ABO-incompatible whole blood, RBCs

  Antibodies in recipients' plasma attach to antigens on transfused RBC = RBC destruction

  S/S - pain/chills/SOB/back pain/AKI

  Red urine appears on next void - need to collect urine

  Collect blood specimen
• Allergic reaction


  • Can be mild/severe

  Flushing/itching/antihistamines

  Monitor closely - may be able to restart but slower rate

  Can lead to anaphylaxis
• Anaphylaxis reaction


  • Airway emergency - rapid response
• Circulatory overload reaction


  • Occurs when blood administered more rapidly that the circulatory system can handle

  S/S cough/dyspnea/chest tightness/tachycardia/pulmonary edema/HTN/restless/JVD
• Actions for circulatory overload reaction

  Stop infusion

  Increase HOB

  Slower rate

  Can be ordered a diuretic
• Sepsis reaction


  • S/S - septic shock, rapid onset chills, high fever, vomiting, diarrhea
• Delayed hemolytic reaction


  • Occurs days/weeks after infusion

  Usually less severe

  No red urine

  Complication in further transfusions
• Hyperkalemia


  • Prolonged storage, cell destruction, improper handling
• Hypocalcemia

  • Preservative used to store blood binds with blood
• universal recipient

  Type Ab
• universal donor

  type o