Patient Introduction Lloyd Bennett is a 76-year-old male who was admitted through the Emergency Department 2...

Patient Introduction

Lloyd Bennett is a 76-year-old male who was admitted through the Emergency Department 2 days ago with a femoral head fracture sustained in a fall outdoors and underwent left hip arthroplasty. All drains have been removed. Provider changed the dressing this morning, and the dressing is currently clean, dry, and intact. Patient has complained of fatigue with physical therapy and does not tolerate changes in position without dizziness. Complete blood count this morning identified hemoglobin of 7 g/dL. The provider has ordered two units of packed red blood cells to be given. The lab has called and the first unit is ready.

1. How did the scenario make you feel?

2. Prior to blood administration, what assessments of the blood product and the patient are required to promote safe delivery and lessen potential complications?

3. What signs and symptoms first indicated the patient was having a transfusion reaction?

4. Review the immediate priorities when a transfusion reaction occurs and the rationale for each.

5. What key elements would you include in the handoff report for this patient? Consider the SBAR (situation, background, assessment, recommendation) format.

6. What follow-up blood work may be required?

7. What follow-up disclosure is required with Lloyd Bennett and his family?

8. What would you do differently if you were to repeat this scenario? How would your patient care change?

Expert Solution

1.The patient is experiencing a post operative complication of anaemia, which are common in hip surgeries. The low level of haemoglobin is the causative factor for the patients dizziness in the physical therapy.This can leaf to function immobility innthe post pprrayive period of a patiwnt and may decrease the early prognosis.

2.Prior to blood administration the following has to be done

Informed consent has to be taken
Collecting a cross matching sample (for blood grouping and cross matching to enable compatability )
Checking for any previous transfusion reactions,allergies
Monitor patient's vital signs
Inform about the benefits and reactions of blood transfusion
Double check the blood product after receiving from the blood bank (expiry date,blood group, infectious disease (HIV,HbsAg,HCV,Malaria)clots,colour
Arrange all the equipment needed for transfusion as it a sterile procedure
If there is no peripheral line ,insert a peripheral line
Administer medication (Avil,Effcorlin) as per order
Monitor vitals for first 15 minutes and the standardise the flow rate and assess the patient throughout the procedure
After transfusion discard the blood bags as per the hospital protocol

The signs and symptoms of blood transfusion reaction are

raise in body temperature
Itching in the body
Blood in the urine
Drop in blood pressure
Breathing difficulty

Nightingale answered 2 years ago

Patient is a 76 year old male who was admitted to the hospital for pulmonary embolism,...

Patient is a 76 year old male who was admitted to the hospital for pulmonary embolism, cardiomyopathy, left ventricular thrombus, ischemic cardiomyopathy. No known allergies. He has history of HTN and hyperlipidemia. Over the past 2 months, he was experiencing SOB particularly with exertion. Patient visited primary care provider on the 29th who directed him to ED for further evaluation. In the ER, found to be afebrile, hemodinamically stable, saturating 95% RA. Lab work-up notable for troponin of 61. CTA...

Patient Introduction Mr. Watkins is a 69-year-old male who presented to the Emergency Department 4 days...

Patient Introduction Mr. Watkins is a 69-year-old male who presented to the Emergency Department 4 days ago with complaints of nausea, vomiting, and severe abdominal pain and was admitted for emergent surgery for bowel perforation. He underwent a hemicolectomy. He has a midline abdominal incision without redness, swelling, or drainage. He is tolerating a soft diet without nausea or vomiting. Bowel sounds are present in all four abdominal quadrants. He had a bowel movement yesterday. Last urinary output was 400...

Mr. Schmidt is a 56 year old male patient who presented to the emergency department with...

Mr. Schmidt is a 56 year old male patient who presented to the emergency department with complaints of left foot pain and swelling, fever and chills for 2-3 days. The client reported increasing discomfort to the foot with noticeable redness that also seems to be worsening. He has an ulcer to the dorsum of the left foot. The client noted that he was seen by his family physician a week ago and a swab was done on the ulcer which...

your patient is a 19- year old male who arrived by ambulance to the emergency department....

your patient is a 19- year old male who arrived by ambulance to the emergency department. He was sitting and talking on the sofa at his girlfriend's apartment when he had a single episode of collapse with seizure-like activity. 1. what are your primary concerns for this patient and what assessments and interventions would be associated with your concerns, and why? 2. what do you anticipate the patient's home medications prior to admission might be, and why? 3. what medications...

Mr. Dugan is an 18-year-old patient who is being admitted from the emergency department with a...

Mr. Dugan is an 18-year-old patient who is being admitted from the emergency department with a diagnosis of sepsis. The patient is a current IV drug user. The patient's vital signs are: T: 104 F, HR:138 RR: 32, and oxygen saturation: 90% at 6 liters per min via high-flow nasal cannula. The patient states "I have been taking my antibiotics like my doctor wants me to, but the infection keeps coming back." The patient is noted to have the following...

A 66-year-old male with a history of COPD is admitted to the emergency department with shortness...

A 66-year-old male with a history of COPD is admitted to the emergency department with shortness of breath. He is not currently taking any medication for his breathing. The patient states that he usually gets short of breath only upon exertion, but he developed a “cold” several days ago that made his breathing worse. He has been placed on oxygen. The doctor wants him to have breathing treatments. What medication, dose, and route of administration would you suggest? (a) How...

27 years old male patient is admitted to the emergency department following a motor cycle accident....

27 years old male patient is admitted to the emergency department following a motor cycle accident. His MR images reveal a C-5 and C-6 spinal nerve injuries.(max 250 words) a) What kind of motor losses of the upper extremity would you expect in this patient? (1 point) b) Which muscles would be affected in this patient?(1 point) c) Which areas of the upper extremity would be affected in means of sensory functions? (1 point) d) Which reflexes would be compromised...

Meet your patient J.S. Mr Singh., a 44-year-old male, was admitted to the emergency department after he...

Meet your patient J.S. Mr Singh., a 44-year-old male, was admitted to the emergency department after he was found comatose in his apartment by his wife. He was diagnosed with diabetes mellitus (Type 2) just 11 months ago andhas been taking 48 U of insulin daily: 12 U of regular insulin plus 20 U of NPH before breakfast, 8 U of regular insulin before dinner, and 8 U of NPH at bedtime. Mr. Singh and his family moved to Toronto from...

The patient is a 92-year old male who was just admitted to your med/surg unit through...

The patient is a 92-year old male who was just admitted to your med/surg unit through the ED for dehydration, hypokalemia, and gastroenteritis of unknown etiology. His past medical history indicates that he has had COPD for 26 years. His COPD has been characterized by a mixture of emphysema, chronic bronchitis, and reactive airway symptoms. 8 years ago he developed right-sided HF, and after a knee replacement 5 years ago his HF became bilateral, and he developed atrial fibrillation. He...

Jackson Smith, a 18 year-old male, was admitted to the Emergency Department at 9pm with severe...

Jackson Smith, a 18 year-old male, was admitted to the Emergency Department at 9pm with severe breathlessness. His family informed you that the patient has a history of Asthma that had been diagnosed when he was two years old. On admission to the Emergency Department the clinical manifestations were: Severe dyspnoea, inability to speak sentences in one breath Respiratory rate of 32 breaths/minute SpO2 94%, on room air Pulse rate of 130 beats/minute Auscultation of lungs identifies diminished breath sounds...

Question