Questions 1. Exercise 1 – Writing Activity

Questions 1. Exercise 1 – Writing Activity This exercise will take approximately 10 minutes to complete. Exercise 1 – 1 Describe the ABO antigen system. 2. Exercise 1 – 2 Describe the Rh antigen system. 3. Exercise 1 – 3 For each blood type listed below, identify the type(s) of blood a patient with that type can receive. (Hint: See Table 40-7 in your textbook.) Patient blood types: A+ A- B+ B- O+ O- AB+ AB- 4. Exercise 2 – Virtual Hospital Activity This exercise will take approximately 30 minutes to complete. Sign in to work at Pacific View Regional Hospital for Period of Care 1. (Note: If you are already in the virtual hospital from a previous exercise, click on Leave the Floor and then on Restart the Program to get to the sign-in window.) From the Patient List, select Piya Jordan (Room 403). Click on Go to Nurses’ Station. Click on Chart and then on403. Click on Laboratory Reports. Exercise 2 – 1 Document the results of Piya Jordan’s hematology tests by filling in the blanks below. On Monday at 2200, the hemoglobin was g/dL and the hematocrit was%. On Tuesday at 0630, the hemoglobin was g/dL and the hematocrit was %. On Wednesday at 0630, the hemoglobin was g/dL and the hematocrit was %. 5. Click on Return to Nurses’ Station. Click on EPR; then click on Login. Select 403 from the Patient drop-down menu and Intake and Output from the Category drop-down menu. Scroll to Tuesday at 1900. Exercise 2 – 2 Why do you think Piya Jordan’s Hgb and Hct are lower on Wednesday? 6. Click on Return to Nurses’ Station. Click on Chart; then on 403. Click on Physician’s Orders. Exercise 2 – 3 What was ordered to correct this problem? Is this appropriate related to Piya Jordan’s level of hemoglobin? Explain why or why not. 7. Click on Return to Nurses’ Station. Click on 403 at the bottom of the screen. Click on Patient Care and then on Nurse-Client Interactions. Select and view the video titled 0735: Pain—Adverse Drug Event. (Note: Check the virtual clock to see whether enough time has elapsed. You can use the fast-forward feature to advance the time by 2-minute intervals if the video is not yet available. Then click again on Patient Care and then on Nurse-Client Interactions to refresh the screen.) Exercise 2 – 4 What does the nurse state she will do to prepare Piya Jordan for a blood transfusion? 8. Exercise 2 – 5 When planning to start an IV for Piya Jordan’s blood transfusion, what gauge needle should be utilized? 14-gauge 20-gauge 22-gauge 26-gauge 9. Exercise 2 – 6 The correct IV fluid to use with a blood transfusion is: normal saline. dextrose in 5% lactated Ringer’s solution. lactated Ringer’s solution. 0.45% normal saline. 10. Exercise 2 – 7 Using Ringer’s lactate (lactated Ringer’s) or dextrose IV solution may result in which two possible consequences? 11. Exercise 2 – 8 What other pretransfusion responsibilities would you complete? (Hint: See Chapter 40 in your textbook.) 12. Click on Chart and then on 403. Click on Laboratory Reports. Exercise 2 – 9 What day and time was the type and cross-match completed? According to your textbook, is this laboratory result acceptable for blood being transfused today? 13. Exercise 3 – Virtual Hospital Activity This exercise will take approximately 30 minutes to complete. Sign in to work at Pacific View Regional Hospital for Period of Care 2. (Note: If you are already in the virtual hospital from a previous exercise, click on Leave the Floor and then on Restart the Program to get to the sign-in window.) From the Patient List, select Piya Jordan (Room 403). Click on Go to Nurses’ Station. Click on 403 to enter Piya Jordan’s room. Click on Patient Care and then on Nurse-Client Interactions. Select and view the video titled 1115: Interventions—Nausea, Blood. (Note: Check the virtual clock to see whether enough time has elapsed. You can use the fast forward feature to advance the time by two-minute intervals if the video is not yet available. Then click on Patient Care and on Nurse-Client Interactions to refresh the screen.) Exercise 3 – 1 Piya Jordan’s daughter verbalizes concern regarding the safety of the blood transfusion. How did the nurse respond to this? 14. Exercise 3 – 2 During the video, the nurse states that the blood has just arrived. How soon should the nurse begin the transfusion? 15. Click on Chart and then on 403. Click on Laboratory Reports. Exercise 3 – 3 What is Piya Jordan’s blood type? 16. Exercise 3 – 4 What type of blood may she receive safely? 17. Exercise 3 – 5 Describe the nurse’s responsibilities during the transfusion. 18. Exercise 3 – 6 How fast would you transfuse this unit of blood? Give your rationale. 19. Exercise 3 – 7 What assessments should be completed on Piya Jordan during the transfusion? 20. Exercise 3 – 8 What would you document regarding this blood transfusion? 21. Exercise 4 – Virtual Hospital Activity This exercise will take approximately 40 minutes to complete. Sign in to work at Pacific View Regional Hospital for Period of Care 4. (Note: If you are already in the virtual hospital from a previous exercise, click on Leave the Floor and then on Restart the Program to get to the sign-in window.) Click on EPR and then on Login. (Remember: You are not able to visit patients or administer medications during Period of Care 4. You are only able to review patient records.) Select 403 from the Patient drop-down menu and Vital Signs from the Category drop-down menu. Exercise 4 – 1 Record Piya Jordan’s vital signs (temperature, heart rate, blood pressure, and respiratory rate) during the transfusion of each of the two units of blood. The first unit vitals start on Wednesday at 1130 and end at 1400. The second unit vitals start on Wednesday at 1415 and end at 1530. Unit 1: Wed 1130 Wed 1145 Wed 1200 Wed 1215 Wed 1315 Wed 1400 Unit 2: Wed 1415 Wed 1430 Wed 1445 Wed 1500 Wed 1515 Wed 1530 22. Exercise 4 – 2 According to the above vital sign assessments, did Piya Jordan have any adverse reactions to the blood transfusions? Explain. 23. Exercise 4 – 3 Of the manifestations listed below, which are among those associated with a hemolytic transfusion reaction? Select all that apply. Hypothermia Chills Apprehension Headache Nausea Low back pain Chest pain Bradycardia Tachypnea Hypotension Hypertension 24. Exercise 4 – 4 What manifestations are consistent with an allergic transfusion reaction? What type of patient is most likely to experience an allergic transfusion reaction. 25. Exercise 4 – 5 How can you determine that Piya Jordan did not have a febrile reaction if she was febrile at the beginning of the transfusion? 26. Exercise 4 – 6 What signs and/or symptoms would you expect to see if Piya Jordan had circulatory overload? 27. Click on Return to Nurses’ Station. Click on Chart and then on 403 to access Piya Jordan’s chart. Click on Expired MARs. Exercise 4 – 7 What other blood product has she received since admission. (Hint: Look at Tuesday’s MAR.) 28. Exercise 4 – 8 How does this product differ from red blood cells (RBCs), and why was it given to Piya Jordan? (Hint: Look at the History and Physical to determine the reason for giving it.) 29. Exercise 4 – 9 How does the administration of this product differ from the administration of RBCs? Ask a new

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