Blood Transfusion worksheet
Directions: Complete these questions as you watch the corresponding videos. Submit completed assignment in D2L dropbox.
Blood Transfusion Procedure (25:32)
1. Blood transfusion: A patient is transfused new _____ via _____ access.
2. What are 2 reasons why someone might need a blood transfusion?
3. What are 2 examples of how someone may experience blood loss?
4. What is the role of RBC’s?
5. List 4 common signs and symptoms seen with low RBC’s.
6. As a general guideline, a blood transfusion is recommended when the hemoglobin is between ______ g/dL.
7. A normal hemoglobin level for a male is between______ g/dL.
8. A normal hemoglobin level for a female is between______ g/dL.
9. Prior to a blood transfusion, prep work is essential in preventing ____.
10. Who will match the blood and prepare the needed units?
11. What type of blood is the universal donor?
12. What blood type can receive blood from any donor?
13. True or False? The nurse must obtain informed consent prior to administering blood products.
14. What items are important to ask the patient prior administering a blood transfusion?
15. If a patient has had numerous blood transfusions in the past, what are they at risk for developing?
16. What is the cause of the reaction identified in question 18?
17. What might the nurse do to prevent this reaction from occurring?
18. What are 2 medications that a patient may be given to prevent a reaction?
19. How long before starting a transfusion should you pre-medicate the patient?
20. Why is it important to know if your patient has heart failure or renal failure prior to transfusing?
21. What medication may be ordered before, between or after a transfusion to help prevent fluid overload?
22. What size IV site is typically recommended for blood transfusions? Why?
23. How long does it typically take to infuse a unit of blood?
24. What is the importance of having an additional or secondary IV site?
25. What type of tubing is required to transfuse blood?
26. What is the ONLY type of IV solution that should be used during blood transfusion?
27. What is the IV fluid used for during a transfusion?
28. What is the proper way to dispose of the empty blood bag and tubing after the transfusion?
29. How many units will the blood bank send you at one time?
30. Once the blood is received by the nurse, how long does the nurse have before the infusion MUST be started?
31. What is the longest amount of time that one unit can be infused over?
32. What can happen if the blood is out of refrigeration longer than 4 hours?
33. True or False? The nurse should be completely ready prior to asking the blood bank to send the blood.
Nugget of Knowledge: What does completely ready mean? Ensuring that informed consent is complete, patient is educated on procedure, the patient has (at least) 2 patent IV sites, 1 that is 18 gauge or larger, proper equipment is in room including vitals signs machine, IV pole with pump, blood tubing is primed with 0.9 normal saline and ready.
34. True or False? You can warm blood up in a microwave.
35. After everything is ready, what MUST be done prior to starting the transfusion?
36. True or False? You must complete the blood/patient verification process with EVERY unit of blood prior to starting the transfusion
Nugget of Knowledge: Do NOT spike the unit of blood prior to completing the verification process. I have had instances where the blood DID NOT match the patient information and needed to be sent back to the blood bank. If the unit of blood is already spiked, it cannot be sent back to the blood bank and it must be thrown away ($$$$$)
37. What items are examined during the verification process?
EVERYTHING MUST MATCH PERFECTLY! NO MATCH=NO TRANSFUSION!
38. True or False? Baseline vital signs must be taken prior to starting the infusion
BONUS QUESTION: What assessment would be important to check prior to infusing blood and why? (think fluid overload)
39. If the patient has a baseline temperature greater than 100.0 F, what should the nurse do PRIOR to starting transfusion?
40. What are signs and symptoms of a transfusion reaction that the nurse needs to be aware of and educate the patient to observe for?
41. If the patient has any of the previous reactions, what should the nurse do IMMEDIATELY?
42. What is the recommended rate to start a blood transfusion at?
43. How long does the transfusion stay at this rate?
44. Why is the transfusion run slowly at first?
BONUS MATH QUESTION: What rate would you set the IV pump at to achieve 2 mL/min?
45. True or False? The nurse MUST stay with the patient during the first 15 minutes of a blood transfusion.
46. After the transfusion starts, when should the first set of vital signs be taken?
47. After the 15 minute vital sign check, if the patient is not having a reaction, what can be done at that time?
BONUS MATH QUESTION: If the unit of blood is 362 mL in volume, approximately what rate should you set the IV pump at to ensure the infusion is complete within 4 hours?
BONUS MATH QUESTION: If the unit of blood is 362 mL in volume, approximately what rate should you set the IV pump at to ensure the infusion is complete within 3 hours?
48. What are the types of reactions a patient can experience while receiving a donor blood transfusion?
49. Fill in the following information to help you remember what adverse signs and symptoms to monitor for.
50. During a hemolytic reaction, what is the recipient’s immune system doing to the donor blood?
51. This mismatch can lead to what adverse outcomes?
52. During an allergic reaction, what is the recipient’s immune system doing to the donor blood?
53. True or False. An allergic reaction to donor blood can lead to an anaphylactic reaction in the patient
54. What is the FIRST thing you do if the patient develops a reaction to a transfusion?
55. What is the second step that should be done after stopping the transfusion?
56. True or False? The nurse needs to notify the MD and the blood bank ASAP after a reaction occurs
Nugget of Knowledge: If the patient experiences a blood transfusion reaction, the nurse should stay with them the entire time. Ask a coworker to get additional supplies and to call the MD and blood bank. If the reaction is severe enough, where the ABC’s are compromised—call a rapid response!
57. Why might the MD order each of the following medications after a transfusion reaction?
58. True or false? If a transfusion reaction occurs, you must send all the tubing and the blood back to lab for additional testing
Each question is worth ½ point. Bonus questions will be added to the total questions answered correctly but will not exceed 100%
Blood Transfusion worksheet