NCLEX Physiological Integrity Pharmacological & Parenteral Therapies COMPLETE REVISION
QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED
What equipment is neeed to adminster blood products? - Answer: blood or blood products, filter tubing, 19 gauge or higher IV What is minimum gauge IV needed to administer blood products? - Answer: 19 gauge What solution is compatible with packed red cells and platelets? - Answer: normal saline Administration of packed red cells - Answer: -reactions less common than with whole blood -use standard filter -use with normal saline -mix cells q 20-30 minutes by squeezing bag -give over 2-4 hrs Adminstration of platelets - Answer: -risks: some febrile reactions -use with nonwettable filter -ABO/Rh compatibility required -no crossmatching required -give as quickly as possible, 4 units/hr
Administration of plasma - Answer: -circulatory overload risk
-administer with straight line set 1 / 2
-give as quickly as possible (coagulation factors become unstable)
Administering blood products - Answer: 1) Gather equipment
2) type and cross match 3) check for bubbles, dark color, cloudiness 4) 2 nurses check! client consent, order 5) baseline vitals 6) start with normal saline 7) slow infusion first 15 mins (2 L/min) 8) recheck vitals after 15 mins 9) stay with patient fo 15-30 mins 10) increase rate 11) vitals q hour for 3 hrs after infusion 12) check vitals q 15 for elderly patients and infuse over 3-4 hrs 15) have patient report itching or flank pain 16) entire IV line changed for each unit of blood How often should vitals be checked with elderly blood transfusion? - Answer: q 15 mins What are signs of adverse reaction in blood transfusion? - Answer: itching, flank pain over kidneys How often must IV lines be changed with blood transfusions? - Answer: with each unit of blood
What to do if transfusionr reaction suspected? - Answer: 1) stop blood infusion
2) restart normal saline 3) save blood container and return to blood bank 4) draw labs for plasma/hemoglobin/culture/retyping 5) monitor urine for hematuria
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