Transfusion Therapy Health Article

KEY TERMS

Antipyretic—A medication used to reduce fever.

Autologous transfusion—The collection, filtration and re-administration of a person's own blood. The blood for an autologous transfusion is collected, filtered, and stored for a patient prior to surgery or may sometimes be salvaged after a traumatic injury or during major surgery.

Clotting factors—Plasma proteins normally found in the blood that work with platelets to help blood clot.

Coagulation—The process of thickening or clotting of the blood.

Hematuria—The appearance of blood or blood cells in the urine.

Hemolytic reaction—A serious transfusion reaction that occurs when donor blood type or Rh factors are not compatible with the recipient's blood. Red blood cell destruction within the body causes symptoms such as shaking, chills, fever, chest pain, difficulty breathing, flank pain, and abnormal bleeding. Hemolytic reactions can lead to major organ failure, shock, and death.

Homologous transfusion—The intravenous delivery of blood or blood products donated by one person (donor) to another person (recipient).

Hyperkalemia—An excess of potassium in the blood which can cause heart muscle irritability and arrhythmias.

Hypocalcemia—A deficiency of calcium in the blood which can cause symptoms of muscle tingling or cramps, nausea, vomiting, lowered blood pressure, and seizures.

Hypoproteinemia—A deficiency of protein in the blood.

Hypothermia—An abnormally low body temperature, usually below 92°F (33.3°C).

Non-hemolytic febrile reaction—An antigen antibody reaction that occurs in 1% of all transfusions. Symptoms include a temperature elevation, chills, palpitations, back pain, chest pain, or headache.

Plasma—The liquid portion of the blood.

Platelets—Small disc-shaped substances found in the blood that assist in blood clotting.

Red blood cells—Cells found in the blood that contain hemoglobin, transport oxygen to body tissue, and are responsible for the red coloring of the blood.

Rh factor—An antigen found on the membrane of red blood cells that will mount an immune response to transfused blood or blood products if not matched correctly before transfusion.

Thrombocytopenia—A persistent deficiency of blood platelets that leads to problems with blood clotting.

White blood cells—White or colorless cells found in the blood that do not contain hemoglobin, but contain a nucleus and help protect the body from infections and disease.

transfusion, change the IV tubing, and run in normal saline slowly. The nurse should keep the line open in the event that drug therapy is needed to reverse the reaction. He or she should elevate the head of the bed, administer oxygen if needed, monitor the patient's vital signs, and contact the physician immediately. The reaction should be documented and the blood bag and tubing returned to the blood bank for testing. There is usually a transfusion reaction protocol in the medical setting for collecting post-reaction blood or urine specimens. If the patient develops itching and a rash during a transfusion, the nurse should slow the flow rate down and contact the physician before stopping the blood. The physician may elect to administer antihistamines and continue the blood transfusion. If the patient develops a low-grade fever during transfusion, the nurse should slow the flow rate and contact the physician before stopping the blood. The physician may elect to administer an antipyretic and continue the transfusion.

Fluid overload can occur (especially in children or the elderly) as a result of a transfusion running too rapidly. The nurse should run blood in slowly (generally over two hours) and monitor the patient closely for restlessness, rapid pulse, or respiratory distress. The flow rate should be adjusted according to the physician's order or the policy of the medical setting. Flow rates may vary according to the product. For instance, the rate for whole blood may be different than the rate for packed cells.