CASE

SCENARIO

A 22-year old woman volunteers to donate blood

at her nearby community blood bank. After the
nurse checks the womans hemoglobin, the
woman is informed that she cannot donate blood
because her hemoglobin level is too low

CASE
SCENARIO

The client is advised to follow-up with her

health care provider, which she does. Ultimately,
she is diagnosed with iron-deficiency anemia
most likely related to insufficient dietary intake of
iron.

QUESTION
#1

How does iron-deficiency anemia,

differ from other forms of anemia?

APLASTIC
ANEMIA
-Damaged
bone marrow
resulting to
aplasia.

IMMUNE
- sickle cell, it HEMOLYTIC

SICKLE CELL

is hereditary - antibodies
and is
resulting to
characterized immunization
of an
by defective
hemoglobin individual to
Rh antigens.
molecule.

MEGALOBLASTIC

- there is
deficient
Vitamin B12
and folic acid
which are
essential for
normal DNA
synthesis thus
resulting to
abnormally
large blood
cells.

IRON DEFICIENCY ANEMIA

The only problem is that of a persons

deficient dietary intake of Iron.

QUESTION
#2

The woman is placed on oral iron

supplements. What should the
woman be taught about this drug?

The drug should be taken on an

empty stomach accompanied by
Vitamin C
Limit intake of dairy
products

To prevent GI
distress:

Start with only one tablet per day for a

few days, then increase to two tablets per
day, then three tablets per day.
use a straw or place a spoon at
the back of the mouth to
take the supplement.
advice the client that
black tarry stool is
normal

QUESTION
#3

When the nurse advises the client to

eat organ meats, the client replies that
she is a vegetarian and does not eat
meat or poultry. What other foods can
the nurse suggest to the client? Prepare
a Sample Meal Plan

BREAKFAST SAMPLE MEAL

cups of oatmeal
with raisins (2mg)

Yogurt (2mg)
Orange juice
Total Fe: 4mg

LUNCH SAMPLE MEAL

2 slices of raisin
bread (2mg)

3 oz. of tuna fish

(4mg)
Lemon Juice
Total Fe: 6mg

DINNER SAMPLE MEAL

1 medium sized
baked potato with
skin (2.8mg)
1 cup mixed green
salad (1.3mg)
1 cup Steamed
broccoli (1mg)
Total Fe: 5.1mg

QUESTION
#4.1

The client has to undergo blood

transfusion. What assessments
need to be made by the nurse prior
to initiating the blood transfusion?

PATIENTS
BLOOD TYPE.
Hx of reaction
type,
manifestation,
interventions
required

Baseline VS,
respiratory, cardiac,
skin and sclera
shoud be assessed

QUESTION
#4.2

About 10 minutes into the transfusion

the client complains of a headache and
chills. The nurse notes that the client is
flushed and anxious. How should the
nurse responds?

STOP TRANSFUSION IMMEDIATELY!

REPORT TO PHYSICIAN
FLUSH IV LINE WITH PNSS THROUGH A NEW
TUBING AT A SLOW RATE.
ASSESS VS, COMPARE IT WITH HER
BASELINE.
NOTIFY BLOODBANK
SEND BLOOD CONTAINER AND TUBING
FOR REPEAT TYPING AND CULTURE

QUESTION
#4.3

Identify other types of transfusion

reactions, its symptoms, & appropriate
management.

FEBRILE NON HEMOLYTIC REACTION

SYMPTOM

MANAGEMENT

chills, minimal to
severe, followed by
fever usually 2 hours
after transfusion has
begun.
Muscle stiffness

Give antipyretics

ACUTE HEMOLYTIC REACTION

SYMPTOM

fever, chills, low back

pain, nausea, chest
tightness dyspnea and
anxiety.
hemoglobinuria,
hypotension,
bronchospasm and
vascular collapse

MANAGEMENT

1. Discontinue
transfusion
2. Obtain blood and
urine specimen.
3. Maintain blood
volume

ACUTE HEMOLYTIC REACTION

SYMPTOM

MANAGEMENT

acute renal failure and

disseminated
intravascular coagulation.

4. For DIC:
Anticoagulant and bed
rest

ALLERGIC REACTIONS
SYMPTOM

MANAGEMENT

urticaria, hives, rashes,

itching, flushing.
If severe there is
bronchospasm, laryngeal
edema and shock.

1. antihistamines before
the transfusion may
prevent future
reactions.
2. severe reactions, future
blood components are
washed

CIRCULATORY OVERLOAD
SYMPTOM
dyspnea, orthopnea,
tachycardia, and sudden
anxiety
Jugular vein distention,
crackles at the base of the
lungs, increase in blood
pressure

MANAGEMENT

If fluid overload is mild, the

transfusion can often be
continued after slowing the
rate of infusion and
administering diuretics.

CIRCULATORY OVERLOAD
SYMPTOM

If the transfusion is
continued, pulmonary
edema can develop, as
manifested by severe
dyspnea and coughing of
pink, frothy sputum.

MANAGEMENT

Thank YOU!

Prepared by: FIRST FIV