Learner Response Summary

Successful
Scenario: Virtual Simulation Blood Transfusion Reaction (082)
Started On September 12, 2023

Question 1

Your Choices:
- Review local policy
- Initiate dedicated intravenous access
- Confirm blood transfusion consent has been obtained
- Confirm type and screen and/or cross and match laboratory testing is completed
- Infuse a compatible intravenous solution through blood administration set to keep vein open

How is consent obtained for blood transfusion?

Your Choices:
- The prescriber obtains written consent

Question 3

Your Choices:
- “There is a small risk for transfusion reaction. We will monitor you closely and ask that you please let us know if you
experience chills, itching, difficulty breathing or pain.”

Is this intravenous solution compatible with blood products?

No response submitted.

Questions 4 NS

Your Choices:
- Yes

Is this intravenous solution compatible with blood products?

No response submitted.
Questions 4 LR

Your Choices:
- No

Is this intravenous solution compatible with blood products?

No response submitted.

Questions 4 D5

Your Choices:
- Yes

Is this intravenous solution compatible with blood products?

No response submitted.

Questions 4 KCL

Your Choices:
- No

Question 5

Your Choices:
- Verify the health care provider’s orders
- Identify patient using at least two, person specific identifiers (i.e., name and date of birth, or name and medical record
number)
- Check expiry date on unit of blood
- Visually inspect blood bag for any signs of contamination or leaks
- Ensure compatibility of blood product with client blood type

Ordered List

Your Choices:
- Initiate infusion within 30 minutes of arrival from blood bank
- Obtain baseline vital signs
- Verify that transfusion record number and patient identification number match
- Administer the blood product within 4 hours of arrival
- Verbally compare and correctly verify patient, blood product, and blood type with another qualified health care
professional

Question 6

No response submitted.

Question 6

Your Choices:
- Immediately assess the client

Question 7

Your Choices:
- Stop the transfusion and call for help

Question 8

Your Choices:
- Re-check vital signs
- Focused respiratory assessment

Question 9 Questions

Your Choices:
- Allergic reaction

How would you reassure the client?

Your Response:
Sometimes reactions like this happen, but I'm right here with you and I'm not going anywhere. I'm going to get some help
and we'll figure out the next steps.

Question 11

Your Response:
Hello, this is Brittany; I'm the nurse taking care of Marissa Grant, a 40-year-old in with a post-partum hemorrhage after
her vaginal delivery earlier today. I'm calling because she seems to be reacting to the blood transfusion ordered for her
low hemoglobin. She has a rash on both arms. Her current vital signs are as follows (read vital signs). She has no
respiratory symptoms, no nausea/vomiting, just the rash on her arms. We've stopped the transfusion and are just
running some maintenance normal saline for now. Should we consider some antihistamines? Okay. So, 50 mg of
benadryl IV x1 now? Okay, thanks. Should we restart, the transfusion? Okay I'll restart the blood transfusion 15 mins
after the benadryl is given if she has no other symptoms.

Question 12

Your Choices:
- Administer antihistamine
- Re-start transfusion

How should nurse Sandy prioritize her patient assignment?

Your Choices:
- Ask charge nurse to re-assign workload to ensure Sandy can closely monitor the client experiencing the transfusion
reaction.

Self-Debriefing & Reflection

Your Response:
In my personal experience, the only blood product I have personally administered to a patient was IVIG. My experience
was a little different from the simulation due to my institution's policies. While in the simulation, the nurse only stayed at
the patient's bedside for the first 15 minutes of the transfusion, while I was required to stay for the duration of the
transfusion.
Similar to the simulation, I have also assisted another nurse who had a patient who had an allergic reaction to the IVIG
transfusion that manifested as a rash. While the nurse stopped the transfusion and began running a bolus of normal
saline, I received orders from the physician to give PO antihistamines and immediately resume the transfusion at a
slower rate. I later found out from the primary nurse that the patient had a history of developing a rash from a previous
transfusion, so the physician was comfortable resuming the current one. Reflecting on that experience, I would probably
have suggested including a prophylactic dose of antihistamines before the transfusion to avoid potential rashes.
No reactions/outcomes surprised me; there were some differences in opinion on the prioritization of actions, but I believe
that was mainly due to my assuming I would complete multiple tasks simultaneously. However, I suppose this was a
good chance to reflect on prioritization in instances I may not be able to multi-task and understand the evidence-based
logic reasoning behind the proper sequence of action.
In the future, I will be sure that I am up to date with my institution's policies on blood transfusion administration, seeing
as that there can be differences between institutions or changes in existing policies. I will also reflect on my prioritization
habits and see where I can make changes to optimize my practice in time-sensitive situations.

Thank you for participating in this virtual simulation.

Your Choices:
- View & Download Results
Session ID: 710460