Chapter 11: Transfusion Therapy
Answer Section
MULTIPLE CHOICE
1. ANS: C
When a unit of blood has finished infusion, the line should be flushed with approximately 20 to 30 mL sodium chloride before the blood administration set is taken down and the new primary administration set is connected.
Reference: Sink, B. (2008). Administration of blood components. In J. D. Roback, M. R. Combs, B. J. Grossman, & C. D. Hillyer (Eds.), Technical manual (16th ed.). Bethesda, MD: American Association of Blood Banking.
PTS: 1 KEY: Cognitive Level: Application
2. ANS: C
An antigen is a substance capable of stimulating the production of an antibody and then reacting with that antibody in a specific way. The substances that can elicit an immunological response in the blood are the A and B antigens. Antibodies are found in the plasma or serum. Anti-B is the antibody in the plasma of a group A antigen.
Reference: Phillips, L. D., & Gorski, L. (2014). Transfusion therapy. Manual of I.V. therapeutics: Evidence-based infusion therapy (6th ed.). Philadelphia, PA: F.A. Davis.
PTS: 1 KEY: Cognitive Level: Application
3. ANS: B
An antigen is a substance capable of stimulating the production of an antibody and then reacting with that antibody in a specific way. If an Rh-negative mother is exposed to an Rh-positive fetus, the mother will build up antibodies in response to the D antigen exposure. After A and B, the most important RBC antigen is the D antigen.
Reference: Phillips, L. D., & Gorski, L. (2014). Transfusion therapy. Manual of I.V. therapeutics: Evidence-based infusion therapy (6th ed.). Philadelphia, PA: F.A. Davis.
PTS: 1 KEY: Cognitive Level: Application
4. ANS: A
Platelets are administered to control or prevent bleeding from platelet deficiencies that result in either thrombocytopenia or the presence of functionally abnormal platelets.
Reference: Phillips, L. D., & Gorski, L. (2014). Transfusion therapy. Manual of I.V. therapeutics: Evidence-based infusion therapy (6th ed.). Philadelphia, PA: F.A. Davis.
PTS: 1 KEY: Cognitive Level: Application
5. ANS: B
Autologous transfusion refers to the collection, storage, and delivery of a client’s own blood. The five types of autologous donation are as follows: (1) predeposit, (2) post-traumatic salvage, (3) perioperative salvage or intraoperative deposit, (4) intraoperative salvage, and (5) postoperative salvage.
Reference: Phillips, L. D., & Gorski, L. (2014). Transfusion therapy. Manual of I.V. therapeutics: Evidence-based infusion therapy (6th ed.). Philadelphia, PA: F.A. Davis.
PTS: 1 KEY: Cognitive Level: Application
6. ANS: D
Standards of practice dictate that if a physician has not ordered the rate, the transfusion must be completed within 4 hours. When a longer transfusion time is clinically indicated, the unit may be divided by the blood bank, and the portion that is not being transfused can be properly refrigerated.
Reference: Sink, B. L. (2008). Administration of blood components. In J. D. Roback, M. R. Combs, B. J. Grossman, & C. D. Hillyer (Eds.), Technical manual (16th ed.). Bethesda, MD: American Association of Blood Banks.
PTS: 1 KEY: Cognitive Level: Application
7. ANS: C
The physician should be notified that the client has refused the treatment. Treatment without the client’s consent is the most frequently alleged act of battery involving nurses. Doing nothing would constitute negligence.
PTS: 1 KEY: Cognitive Level: Analysis
8. ANS: B
Diuretics, such as furosemide, may be administered to prevent or correct circulatory overload. Furosemide may lower blood pressure, but this is not why it is administered to this client. It is not given to counteract hypercalcemia and does not prevent pulmonary emboli.
Reference: Sink, B. L. (2008). Administration of blood components. In J. D. Roback, M. R. Combs, B. J. Grossman, & C. D. Hillyer (Eds.), Technical manual (16th ed.). Bethesda, MD: American Association of Blood Banks.
PTS: 1 KEY: Cognitive Level: Application
9. ANS: B
Viral hepatitis is still a serious risk in transfusion. With the current screening procedures, a recipient’s chance is 1 in 200,000 that a pint of blood may result in a non-A or non-B viral hepatitis. Currently, the risk of a transfusion-associated HIV infection is remote—no greater than 1 in 825,000.
Reference: Eberhard, W., Fiebig, M. D., & Busch, M. P. (2008). Infectious disease screening. In J. D. Roback, M. R. Combs, B. J. Grossman, & C. D. Hillyer (Eds.), Technical manual (16th ed.). Bethesda, MD: American Association of Blood Banks.
PTS: 1 KEY: Cognitive Level: Application
10. ANS: C
American Association of Blood Banks (AABB) standards require that blood be infused within 4 hours because of warming of the blood at room temperature and increasing debris in the blood filter.
Reference: Sink, B. L. (2008). Administration of blood components. In J. D. Roback, M. R. Combs, B. J. Grossman, & C. D. Hillyer (Eds.), Technical manual (16th ed.). Bethesda, MD: American Association of Blood Banks.
PTS: 1 KEY: Cognitive Level: Application
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