University revision · Fundamentals of Nursing

Risk Management and Patient Safety

Question 1 of 40 Course: Nursing(Degree)

What is a 'sentinel event'?

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Vital signs monitoring, especially during the first 15 minutes, is critical for early detection of transfusion reactions. Baseline vitals are taken before transfusion, then at 15 minutes after start, and hourly until completion. The nurse must remain with patient during first 15 minutes when severe reactions often occur. Signs of reaction: fever, chills, itching, rash, respiratory distress, chest/back pain, hypotension, tachycardia, hemoglobinuria. Transfusion should be stopped immediately for suspected reaction, IV line kept patent with normal saline, notify physician, and send blood bag/tubing to lab. Other nursing responsibilities: verifying consent; two-nurse verification of blood product and patient identity; using blood administration set with filter; infusing within 4 hours; monitoring for fluid overload; and patient education about reporting symptoms. Different reactions include: acute hemolytic (ABO incompatibility - most serious); febrile non-hemolytic; allergic; TRALI; TACO; and bacterial contamination.

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