Question

A 13-year-old adolescent with sickle cell disease is being admitted for RBC transfusion therapy. Explain potential complications from transfusion therapy and the nurse’s role in prevention.

Answer 1

Blood transfusion remains an important therapeutic intervention in patients with sickle cell disease.

Complications from transfusion therapy-

Iron overload, delayed hemolytic transfusion reaction, multisystem organ failure, and hyperviscosity along with usual transfusion risks. Repeated transfusions create alloimmunization in SCA patients

Iron overload is the build-up of iron in the body due to the excess presence of iron in the blood. Transfusional iron overload is commonly seen in patients who take multiple transfusions. Delayed hemolytic transfusion reaction presents with red blood cell hemolysis from 2 days to several months after a transfusion. This leads to the absence of expected results. Multisystem organ failure is a condition in which multiple systems of the body fails to perform their function. Hyperviscosity prevents blood from flowing freely through the arteries. Here it is caused due to the excess amount of blood in the system.

Nurses role-

The nurse should thoroughly check the previous records of the client to be aware of the potential complications. The nurse should continuously evaluate the vital signs of the patient. The nurse should be aware of complications while transfusing blood to a child with SDA, Nurse should be capable to assess splenomegaly, hyperviscosity, shock, chest pain, and so on. Nurses should be ready to manage any situation. The nurse should continuously monitor the drop factor and ensure the rate of flow to prevent complications and overload. If any abnormality is observed the nurse should immediately stop the transfusion and keep the line open with normal saline. Notify the physician at the earliest The nurse should monitor symptoms of complications like iron overload, delayed hemolytic transfusion reaction, multisystem organ failure, and hyperviscosity.