Ati Chapter 41 Blood and Blood Product Transfusions
Why someone might need a blood transfusion:
1. Losing a lot of blood (from injury or surgery)
→ Give PRBCs (Packed Red Blood Cells) to replace the lost blood.
2. Anemia (low red blood cells, Hemoglobin 6-10 g/dL)
→ Give PRBCs to increase red blood cells and improve oxygen in the body.
3. Kidney failure
→ Give PRBCs because the kidneys aren't making enough of a hormone that helps
create red blood cells.
4. Problems with clotting factors (like hemophilia)
→ Give FFP (Fresh Frozen Plasma), which has the clotting proteins needed to stop
bleeding.
5. Low platelets (thrombocytopenia) or platelets not working right
→ Give platelets to help the blood clot better.
6. Hemophilia A(a specific bleeding disorder)
→ Give cryoprecipitate, which contains specific clotting factors like Factor VIII.
7. Burns or very low protein levels in the blood (hypoproteinemia)
→ Give albumin, a protein that helps keep fluid in the blood vessels.
Transfusion Considerations (What to remember for each
type of transfusion)
🧬 Platelet Transfusion
Blood type match not required
Amount: 200–300 mL
Give over: 15–30 minutes
Use: Special transfusion set with a small filter and short tubing
Check vital signs:
Before starting
15 minutes after starting
After it's done
🧊 Plasma Transfusion (Fresh Frozen Plasma - FFP)
Must thaw before giving
Needs ABO blood type match
Amount: About 200 mL
Give over: 30–60 minutes
Use: Standard Y-tubing or straight tubing with a filter
,🦠 WBC (White Blood Cell) Transfusion
High risk of reaction, especially for patients with weak immune systems
Special note: If the patient is on Amphotericin B (a strong antibiotic),
wait 4–6 hours before or after WBC transfusion
Amount: About 400 mL
Give over: 45–60 minutes
Check vitals: Every 15 minutes
🩸 Washed Red Blood Cells (RBCs without WBCs)
Used for patients who had past bad reactions to transfusions or had a stem cell
transplant
Amount: 200 mL
Give over: 2–4 hours
Pre-Transfusion Preparation (Before giving any blood
product)
1. Type and Crossmatch
Make sure the patient's blood type (ABO and Rh) is compatible with donor
blood
2. Nursing Actions:
Explain the procedure to the patient
Check vital signs and temperature
Look at lab values to confirm that a transfusion is needed
Double-check the doctor’s order (Rx)
Get informed consent from the patient
Collect blood samples for testing
Ask if the patient had any past reactions to transfusions
Use a large IV needle (18–20 gauge)
Pick up blood from the blood bank
Prime the tubing with normal saline (NS) only
Use Y- Tubing with a filter
Use a blood warmer if needed to prevent chilling the patient
, Class 2: Hypertension (HTN) **adherence to Anti-HTN medications
HTN can have rebound HTN crisis HTN crisis -- >180/>120 =
stroke out Treatment - nitroglycerin IV drip ** be careful not to
drop the BP to drop too fast
Hypertension (Mayo Clinic, Saunders) Where? The anatomy of arteries. What? Pathophysiology
pressure >130/80 stage 1 >120/80 pre-HTN. Why? Etiology Cause- primary: the patient genetic
themselves Secondary: sickness (renal failure, diabetes (blood full of sugar which is thicker
blood harder to pump which will raise BP, atherosclerosis) Risk factor: smoking, age/older,
alcohol, obesity, gender (males), lifestyle, African Americans, family history/genetics stress.
Hypertension: Assessment & Clinical Manifestations
General Overview:
"Silent Killer": Often asymptomatic until target organ damage occurs.
If Symptomatic, assess for:
o Headaches (especially in the morning)
o Chest pain
o Dizziness or lightheadedness
o Blurred vision
o Fatigue / Activity intolerance
o Palpitations
o Shortness of breath (SOB) / Dyspnea on exertion (DOE)
Recognizing Complications (Target Organ Damage):
🫀 Heart
Pathophysiology:
o High BP = increased workload → Left Ventricular Hypertrophy (LVH)
o Over time → Cardiomyopathy (seen on chest X-ray)
o Increased O2 demand but insufficient supply → Heart Failure
Assessment Findings:
o Chest pain, SOB, fatigue
o Hypotension in late-stage HF
o Edema, crackles in lungs (if left-sided HF)
🧠 Brain
Risks:
oStroke: Ischemic (lack of blood) or Hemorrhagic (vessel rupture)
Symptoms:
Why someone might need a blood transfusion:
1. Losing a lot of blood (from injury or surgery)
→ Give PRBCs (Packed Red Blood Cells) to replace the lost blood.
2. Anemia (low red blood cells, Hemoglobin 6-10 g/dL)
→ Give PRBCs to increase red blood cells and improve oxygen in the body.
3. Kidney failure
→ Give PRBCs because the kidneys aren't making enough of a hormone that helps
create red blood cells.
4. Problems with clotting factors (like hemophilia)
→ Give FFP (Fresh Frozen Plasma), which has the clotting proteins needed to stop
bleeding.
5. Low platelets (thrombocytopenia) or platelets not working right
→ Give platelets to help the blood clot better.
6. Hemophilia A(a specific bleeding disorder)
→ Give cryoprecipitate, which contains specific clotting factors like Factor VIII.
7. Burns or very low protein levels in the blood (hypoproteinemia)
→ Give albumin, a protein that helps keep fluid in the blood vessels.
Transfusion Considerations (What to remember for each
type of transfusion)
🧬 Platelet Transfusion
Blood type match not required
Amount: 200–300 mL
Give over: 15–30 minutes
Use: Special transfusion set with a small filter and short tubing
Check vital signs:
Before starting
15 minutes after starting
After it's done
🧊 Plasma Transfusion (Fresh Frozen Plasma - FFP)
Must thaw before giving
Needs ABO blood type match
Amount: About 200 mL
Give over: 30–60 minutes
Use: Standard Y-tubing or straight tubing with a filter
,🦠 WBC (White Blood Cell) Transfusion
High risk of reaction, especially for patients with weak immune systems
Special note: If the patient is on Amphotericin B (a strong antibiotic),
wait 4–6 hours before or after WBC transfusion
Amount: About 400 mL
Give over: 45–60 minutes
Check vitals: Every 15 minutes
🩸 Washed Red Blood Cells (RBCs without WBCs)
Used for patients who had past bad reactions to transfusions or had a stem cell
transplant
Amount: 200 mL
Give over: 2–4 hours
Pre-Transfusion Preparation (Before giving any blood
product)
1. Type and Crossmatch
Make sure the patient's blood type (ABO and Rh) is compatible with donor
blood
2. Nursing Actions:
Explain the procedure to the patient
Check vital signs and temperature
Look at lab values to confirm that a transfusion is needed
Double-check the doctor’s order (Rx)
Get informed consent from the patient
Collect blood samples for testing
Ask if the patient had any past reactions to transfusions
Use a large IV needle (18–20 gauge)
Pick up blood from the blood bank
Prime the tubing with normal saline (NS) only
Use Y- Tubing with a filter
Use a blood warmer if needed to prevent chilling the patient
, Class 2: Hypertension (HTN) **adherence to Anti-HTN medications
HTN can have rebound HTN crisis HTN crisis -- >180/>120 =
stroke out Treatment - nitroglycerin IV drip ** be careful not to
drop the BP to drop too fast
Hypertension (Mayo Clinic, Saunders) Where? The anatomy of arteries. What? Pathophysiology
pressure >130/80 stage 1 >120/80 pre-HTN. Why? Etiology Cause- primary: the patient genetic
themselves Secondary: sickness (renal failure, diabetes (blood full of sugar which is thicker
blood harder to pump which will raise BP, atherosclerosis) Risk factor: smoking, age/older,
alcohol, obesity, gender (males), lifestyle, African Americans, family history/genetics stress.
Hypertension: Assessment & Clinical Manifestations
General Overview:
"Silent Killer": Often asymptomatic until target organ damage occurs.
If Symptomatic, assess for:
o Headaches (especially in the morning)
o Chest pain
o Dizziness or lightheadedness
o Blurred vision
o Fatigue / Activity intolerance
o Palpitations
o Shortness of breath (SOB) / Dyspnea on exertion (DOE)
Recognizing Complications (Target Organ Damage):
🫀 Heart
Pathophysiology:
o High BP = increased workload → Left Ventricular Hypertrophy (LVH)
o Over time → Cardiomyopathy (seen on chest X-ray)
o Increased O2 demand but insufficient supply → Heart Failure
Assessment Findings:
o Chest pain, SOB, fatigue
o Hypotension in late-stage HF
o Edema, crackles in lungs (if left-sided HF)
🧠 Brain
Risks:
oStroke: Ischemic (lack of blood) or Hemorrhagic (vessel rupture)
Symptoms:
