Blood Administration Quiz

1. A 70 year old female who is thrombocytopenic due to recent chemotherapy for acute myelogenous leukemia is scheduled to receive a single unit of apheresis- derived, irradiated, leukocyte-reduced platelets. You walk in just as the transfusion is about to begin and see that the nurse is about to spike the unit with a standard IV infusion set connected directly to her left arm. You say:

2. A "microaggregate" blood filter has an approximate filter screen size of:

3. A nurse who is transfusing a patient with two units of red blood cells, one unit of apheresis platelets, and two units of fresh frozen plasma (FFP) calls you. She says that the hospital materials department is running short on blood infusion sets, and wants to know if there is any way to minimize the number of sets she uses while transfusing these products. Which of the following is the best advice?

4. Fill in the blanks: In general, red blood cell transfusions should start at a flow rate of approximately __ ml/min for the first __ minutes of the transfusion.

5. The transfusion service lab scientist puts 2 units of red blood cells directly in the hands of a "runner" from the Cardiac ICU (no "cooler" is used). The units are intended for transfusion to a 66-year-old male who had an acute myocardial infarction two days ago and now has a hemoglobin of 7.5 g/dl. He has mild congestive heart failure, so the cardiologist has requested that the units be infused slowly. How long does the transfusionist have to transfuse the two units to this patient?

6. A unit of red blood cells is signed out of the transfusion service at 9:00 am, to be given to an oncology patient who has come in to the facility for an outpatient transfusion. At 9:45 am, the nurse responsible for the transfusion calls to report that before she could spike the unit, the patient's initial IV failed, and that the staff are having a very hard time re-establishing access. The nurse, who happens to be a regular blood donor, does not want the unit to go to waste, so she asks your help. She states that the unit still feels cool to the touch. Which of the following is your advice about this unit?

7. An anesthesiologist wants to return a unit of red blood cells which was not used during surgery. Which of the following is a TRUE statement regarding the transfusion service's ability to accept and later reissue the unit?

8. Which of the following is a TRUE statement regarding the administration of blood products?

9. Which of the following is an acceptable solution to be infused in the same intravenous line with a blood component?

10. A 65 year old female with gram-negative sepsis secondary to a ruptured colon is receiving a red cell transfusion. Her temperature has been fluctuating wildly between 37C up to a maximum of 39.6C for the past 8 hours. Prior to the start of the transfusion, her temperature is 38C. Thirty minutes into the transfusion, however, her temperature is 39.5C. She does not appear agitated, and her other vital signs are unchanged. What is the FIRST thing that the person responsible for infusing the blood should do?

11. Which of the following is TRUE about premedication of patients before they receive transfusion?