Antigen: A

Antibodies against: B

Compatible with: A+/- and O +/-

Antigen: A

Antibodies against: B

Compatable with A- or O-

Antigen: B

Antibodies against: A

Compatabile with B+/- or O+/-

Antigen: B

Antibodies against: A

Compatible with B- or O-

Antigen: AB

Antibodies against: O

Compatible with: A+/-, B+/-, AB +/-, or O+/-

Antigen: O

Antibodies against: A, B

Compatible with O+/-

Antigen: O

Antibodies against: A, B

Compatible with O-

1) Transfusions from blood donors

2) Autologous transfusion: client's own blook is collected in anticipation for future transactions.

3) Intraoperative blood salvage: Blood loss during certain surgeries can be be recycled through a cell-saver machine and transfused during or after surgery.

- Excessive blood lost (Hgb  6-10 g/dL & depending on symptoms) = Whole Blood

- Anemia - (Hgb 6-10 g/dL and depending on symptoms) = Packed RBC's

Chronic Renal Failure = packed RBC's

- Hemophilia (& other Coagulation Factor deficiencies) = Fresh Frozen plasma

Thrombocytopenia/platelet dysfunction (plt < 20,000 or < 80,000 and actively bleeding) = platelets

1) Assess lab values (esp. Hgb & Hct)

2) Verify order

2) Obtain blood samples for compatability determination

4) Large bore IV access

5) Assess for hx of rxns

6) Inspect blood for discoloration, bubbles, cloudiness

7) Verify client's name, blood compatibility, and expiration date with another nurse (need two sigs).

7) Prime with NS (NEVER add meds to blood products)

8) Ascertain if filter should be used

9) Baseline VS

10) Begin transfusion

1) Remain with client during 1st 15 mins

2) Moniter VS

3) Rate of infusion

4) Respiratory status

Rxn? = sudden increase in anxiety? breath sounds? neck vein distention?

*Notify doc immediately for any signs of rxn & remember to retake VS; stop transfusion immediately and initiate a saline infusion. Save blood bag and remaining blood & tubing for testing.

Complete transfusion w/in 2-4 hrs.

1) Obtain VS

2) Dispose of blood-administration set in biohazard bags

3) Monitor blood values (CBC, Hgt, Hct) - Hgt levels rise approx 1 g/dL per unit of blood

4) Complete paperwork/document

- Immediate onset transfusion rxn

- Can be mild or life-threatening

- Symptoms: chills, fever, low backpain, tachycardia, flushing, hypostension, chest tightening or pain, tachypnea, nausea, anxiety, and hemoglobinuria.

- Can cause: CV collapse, acute renal failure, disseminated intravscular coagulation, shock, and death.

- Symptoms: dyspnea, chest tightness, tachycardia, tachypnea, headache, hypertension, jug-vein distention, peripheral edema, orthopnea, sudden anxiety, and crackles in the base of the lungs.

- Administer O2, VS, slow infusion rate and admin diuretics as ordered

- Call doc immediately

- Onset 30 mins-6 hrs. after transfusion

- Symptoms: chills, fever, flushing, headache, and anxiety.

- Use white blood cell filter and admin antipyretics.

- Rxn during or up to 24-hrs after transfusion

- Sypmtoms: itching, uticaria, and flushing.

-Administer antihistamines (i.e. Benedryl)

- Immediate onset rxn

- Symptoms: wheezing, dyspnea, chest tightness, cyanosis, and hypotension

- Maintain airway; admin O2, IV fluids, antihistamine, coricosteroids, vasopressors.

Sepsis/Septic Shock

- Symptoms: fever, nausea, vomiting, abdominal pain, chills, and hypertension

- maintain airway, admin O2

- Antibiotic therapy as ordered

- samples for blood cultures

- Admin vasopressors (i.e. dopamine) in late phase

- Elevate pts feet

- If DIC (disseminated intravascular coagulation) occurs:

1) Admin anticoagulants (Heparin) - early phase

2) Admin clotting factors and blood products - late stage

3) Admin activated protein C (Xigris) - for inflammatory response

- If cardiac or renal dysfunction - increased risk for heart failure and fluid-vol excess

- Venous access may be limited

- Assess VS more frequently because changes may be sole indicators of fluid overload or rxn