Transfusion Reaction Essay

Hypovolemic shock is an urgent condition of rapid reduction of circulatory volume in the body, which can be created due to blood or plasma or body fluids loss (Kettley & Marsh, 2016, p. 31; Perner & Backer, 2014, p. 613). Blood loss can be induced by internal or external injuries, excessive perspiration or diuretics (Craft & et al, 2015, p. 852). Maureen Hardy’s hypovolemia has been precipitated by hematemesis.

Cardiogenic shock is a frequently fatal complication that occurs when the heart cannot pump an adequate amount of blood in order to perfuse tissues. This hypoperfusion causes multiple organ dysfunction and damage which classifies cardiogenic shock a medical emergency. In the past, cardiogenic shock had a poor prognosis. However, currently approximately half of the people that go into cardiogenic shock survive (National Heart, Lung, and Blood Institute [NHLBI], 2011).

William Osler once said “Medicine is the science of uncertainty and the art of probability.” While this quote was said nearly one-hundred years ago, it still holds the same weight as is once did. In Bloodletting and Miraculous Cures by Vincent Lam, this quote is shown to not only be true in regards to medicine, but also for people as a whole; even so there are many factors that contribute to a person’s personality early on that can be traced to decisions and personality traits later in their lives. One of these factors is the amount of interaction and influence a person’s family has with them. In Bloodletting and Miraculous Cures, there are two extreme examples

unit, her BP was 94/56 and her pulse 110, but now her BP is 110/70 and her

Cardiogenic shock is results from damage to the heart such as a heart attack. In cardiogenic shock the heart is damaged and unable to supply a sufficient amount of blood to the body and the body cells do not receive enough oxygen (Huether & Mccance, 2012). Symptoms of cardiogenic shock are chest pain or pressure, coma, decreased urination, fast breathing, fast pulse, heavy sweating and moist skin, lightheadedness, loss of alertness and ability to concentrate, restlessness, agitation, confusion, shortness of break, skin that feels cool to touch, pale skin color or blotchy skin, and/or weak pulse (Dugdale, Cardiogenic Shock, 2012). Treatment of cardiogenic shock includes medications to increase blood pressure sucj as dobutamine, dopamine, milirione, and more. Urgent treatment includes electrical shock therapy (defibrillation or cardio version), implanting a temporary pacemaker and medications given through the vein, pain medicine, oxygen, fluids, and blood or blood products (Dugdale, Cardiogenic Shock, 2012). Cardiogenic shock

Venkataraman, Ramesh, and Michael R. Pinsky. "Toxic Shock Syndrome." Medscape. 16 July 2010. Web. 17 Oct. 2011. <http://emedicine.medscape.com/article/169177- overview>.

successful transfusion of human blood. He performed this act to a patient for the treatment of

Mr. Steward’s priority problems include impaired cardiac tissue perfusion, impaired gas exchange, and pain. We are concerned about impaired cardiac tissue perfusion because the pt. is exhibiting signs of myocardial ischemia including chest pain and shortness of breath (Gillespie, 2012). Although we acknowledge that impaired cardiac tissue perfusion can decrease the function of the heart and will have the potential to affect the perfusion and delivery of oxygen to other end organs, our primary focus will be a focused cardiovascular assessment (House-Kokan, 2012). At 1800, Mr. Steward was SOB, had shallow and rapid breathing (RR = 44), and a SaO2 of 72% on RA. Due to the fluid buildup in his lungs, Mr. Steward has impaired gas exchange, and requires supplemental oxygen to maintain his SaO2; this warrants a focused respiratory assessment.

She has an ostomy. She was fresh from surgery yesterday, so they gave her pain meds to manage the pain. When I first walked into the room, I learned that she was making snore-liking sounds when she was breathing. From what I have learned, it is called rhonchi. She had many secretions going on. What I was concerned of was how much oxygen she was getting in. I looked at her last vital signs and found that she was had a 92 percent o2 sat level. I was also concerned about her aspirating. Therefore, we had to make sure her HOB 30-45 degrees. I made sure the side rails were up x3 because of fall precaution. She was comfortable most of the time but I taught her but the risk for pressure sores. She understood the need turn frequently to prevent pressure sores. Later I looked in her labs and found that her hemoglobin at 7.1. She was a candidate for blood transfusion. The nurse was teaching me how blood transfusions are done. Before they give her blood, they have to get her last vital signs. We were consistently checking her vitals as we were giving her a blood transfusion. After giving her blood, we had to monitor her and her vital signs for any transfusion reaction. The symptoms of transfusion reaction is shortness of breath and depressed vital signs. Later we found that her oxygen level was at a 93 percent. Afterwards, I looked into her chart and found that he had an XRAY done, which revealed

A sudden worsening of anemia resulting from infection or enlargement of the spleen is a common reason for a transfusion. Multiple blood transfusions, however, might cause health problems because of the iron content in the blood. Iron overload, called hemosiderosis, can damage liver, heart, pancreas and other organs also leading to diseases such as diabetes mellitus. Iron chelation therapy should be started in patients with SCD receiving regular blood transfusions to reduce excess iron levels. Infections are treated with antibiotic medicines and sometimes blood transfusions. At the first sign of an infection, such as a fever, it is important to see a doctor right away as this may represent a medical emergency for people with SCD (Hurston 2018). Early treatment of infection can help prevent problems and even save

Patients requiring reversal of VKA often present with increased INR and subsequent hemorrhage. Researchers have identified several patient characteristics that increase the risk of refractory bleeding including intensity of anticoagulation, age, hypertension, cerebrovascular disease, ischemic stroke, heart disease, diabetes, renal insufficiency, alcoholism, liver disease and malignancy.8 Overdose for VKAs frequently occurs as a result of inappropriate dosing, changes in protein binding, decrease in vitamin K intake, reduced synthesis/increased clearance of vitamin K factors, and use of other medications. Many

Shock is described as a state of hypoperfusion of the organs and tissues, which results in cellular dysfunction and cell death. There are many varieties of shock, but for the purpose of this essay I will focus on hypovolemic shock. The term hypovolemic means low volume; this term in and of itself tells us what the root cause of this form of shock is, low blood volume. There are two different types of hypovolemic shock, hemorrhagic and non hemorrhagic. I will be discussing the possible causes, signs, symptoms, and treatment options for the hemorrhagic type. I will also explain what health care providers in the field should be looking for to determine whether the patient is in a state of compensated or decompensating shock. Compensated shock is when the body is using all of it’s resources to maintain perfusion but in the later stages of shock the patient will decompensate, this is when the body’s attempts at maintaining perfusion are beginning to fail.

Controlling infections in the hospital setting has been a major issue for hundreds of years. Patients have largely been effected by pathogens transferred from those appointed to care for them. Florence Nightingale became famous for changing the way we practice patient care. Her idea was simple yet powerful and it is still considered the standard worldwide. She promoted hand washing in order to reduce healthcare infections. Flash-forward a hundred years and we are now seeing infections increase through a different route. The CDC estimated about 31,100 central line associated blood stream infections occur each year (Control, 2015). According to the Centers for Disease Control and Prevention, the most commonly reported pathogens include coagulase-negative staphylococci, Staphylococcus aureus, enterococci, and Candida. (Tavianini, Deacon, Negrete, & Salapka, 2014). Although central lines was not yet a technology created in healthcare, implementing the fundamental skills as emphasized by Nightingale

Respiratory Perfusionist There are many subspecialties of Respiratory Therapy, one of them being a Respiratory Perfusionist. A Respiratory Perfusionist works primarily in an operating room along side surgeons and anesthesiologists during cardiac surgery. Some perfusionist may also work in cardiovascular intensive care units, as well as a catheterization laboratory. Now perfusionists are becoming more incorporated in more than just cardiac surgeries and cardiac care.

T.C. is a 30-year-old woman who 3 weeks ago underwent a vaginal hysterectomy and right salpingooophorectomy for abdominal pain and endometriosis. Postoperatively she experienced an intraabdominal hemorrhage, and her hematocrit (Hct) dropped from 40.5% to 21%. She was transfused with 3 units of packed RBCs (PRBCs). After discharge she continued to have abdominal pain, chills, and fever and was subsequently readmitted twice: once for treatment of postoperative infection and the second time for evacuation of a pelvic hematoma. Despite treatment, T.C. continued to have abdominal pain, chills, fever, and nausea and vomiting (N/V).