Blood Transfusion on the NCLEX
PRBC, FFP, platelets, cryo, when each, transfusion reactions.
Transfusion has indications, monitoring, and reaction recognition.
Components
PRBC: anemia, blood loss. FFP: coagulopathy (warfarin reversal, liver disease). Platelets: thrombocytopenia. Cryo: fibrinogen, von Willebrand, factor VIII.
Pre-transfusion
Type & cross. Consent. Two-RN verification at bedside. Baseline vitals. IV access (18-20 gauge ideal). Y-tubing with NS only.
Monitoring
Vital signs baseline, 15 min, then per protocol. Start slow first 15 min (highest risk for reaction).
Reactions
Acute hemolytic: fever, chills, flank pain, hemoglobinuria. STOP. NS via new tubing. Notify. Send blood and tubing back to blood bank. Febrile non-hemolytic: fever, chills. Slow or stop. Antipyretic. Often reaction to donor leukocytes. Allergic: urticaria. Slow. Antihistamine. Anaphylactic: hypotension, respiratory distress. STOP. Epi. ACLS. TRALI: respiratory distress within 6h. Supportive. TACO: fluid overload.
Frequently asked
Use D5 with blood?
No, causes hemolysis. NS only.
Premedicate routinely?
Not routine. For known reaction history.
Quick check
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