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?

Solutions

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 1 year ago

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