BLOOD TRANSFUSION		version 12/30/2024		

Nursing Orders 	

	
	Interval	Defer Until	Duration	
	☑	Nursing communication	Every visit	S	Until discont'd	
		Please continue to schedule subsequent infusion appointments manually as appropriate.		

Appointment Requests 	

	
	Interval	Defer Until	Duration	
	☑	Referral to IV Infusion Room	Once	S	1 treatment	
		Status: Future, Expected: S, Expires: S+365, Clinic Performed
	Urgency of Scheduling: Routine		

Labs 	

	
	Interval	Defer Until	Duration	
	☑	Type and screen	Every visit	S	Until discont'd	
		Normal, Clinic Collect		

Nursing Pre-Transfusion Orders 	

	
	Interval	Defer Until	Duration	
	☑	Consent obtained	Every visit	S	Until discont'd	
		The Benefits vs Risks of Blood and Blood product transfusion have been discussed with this patient.
	Has consent been obtained? Yes		
	☑	Maintain IV Access	Every visit	S	Until discont'd	
		No details available for preview		
	☑	Vital signs - T/P/R/BP Per Unit Protocol	Every visit	S	Until discont'd	
		Monitor Vital Signs before transfusion starts, 15 minutes after transfusion starts, and at completion of transfusion.  Notify physician of any abnormal vital signs.		
	☑	Transfusion Reaction Evaluation	Every visit	S	Until discont'd	
		Transfusion Reaction Evaluation: In the event of a transfusion reaction do the following: 1) Immediately stop the transfusion   2) Start Normal Saline Intravenous infusion  3) Notify ordering physician and Transfusion Medicine Services (blood bank)   4) Document the suspected transfusion reaction (refer to HMH Policy and Procedure NU1303)    5) Obtain post-transfusion type and screen.		

Transfusion Product 	

	
	Interval	Defer Until	Duration	
	☑	Prepare RBC	Every visit	S	Until discont'd	
		Routine, Blood		

Nursing Transfusion Orders 	

	
	Interval	Defer Until	Duration	
	☑	Transfuse RBC	Every visit	S	Until discont'd	
		Transfuse {Blood Units:115902732} PRBC's for Hemoglobin less than {Hemoglobin Values:115902733}.		

Pre-Medications 	

	
	Interval	Defer Until	Duration	
	☐	acetaminophen (TYLENOL) tablet 650 mg	Every visit	S	Until discont'd	
		650 mg, oral, once, Starting when released
	Administer 30 minutes prior to blood transfusion.
	Maximum of 4 grams of acetaminophen per day from all sources. (Cirrhosis patients maximum: 2 grams per day from all sources).		
	☐	diphenhydrAMINE (BENADRYL) tablet 25 mg	Every visit	S	Until discont'd	
		25 mg, oral, once, Starting when released
	Administer 30 minutes prior to blood transfusion.		
	☐	diphenhydrAMINE (BENADRYL) injection 25 mg	Every visit	S	Until discont'd	
		25 mg, intravenous, once, Starting when released
	Administer 30 minutes prior to blood transfusion.		
	☐	famotidine (PEPCID) tablet 20 mg	Every visit	S	Until discont'd	
		20 mg, oral, once, Starting when released
	Administer 30 minutes prior to blood transfusion.		
	☐	famotidine (PEPCID) injection 20 mg	Every visit	S	Until discont'd	
		20 mg, intravenous, once, Starting when released
	Administer 30 minutes before blood transfusion		
	☐	fexofenadine (ALLEGRA) tablet 180 mg	Every visit	S	Until discont'd	
		180 mg, oral, once, Starting when released
	Administer 30 minutes prior to blood transfusion.		
	☐	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Every visit	S	Until discont'd	
		100 mg, intravenous, once, Starting when released
	Administer 30 minutes prior to blood transfusion.		
	☐	methylPREDNISolone sodium succinate (Solu-MEDROL) injection 10 mg	Every visit	S	Until discont'd	
		10 mg, intravenous, once, Starting when released
	Administer 30 minutes prior to blood transfusion.		
	☐	methylPREDNISolone sodium succinate (Solu-MEDROL) injection 40 mg	Every visit	S	Until discont'd	
		40 mg, intravenous, once, Starting when released
	Administer 30 minutes prior to blood transfusion.		

IV Fluids 	

	
	Interval	Defer Until	Duration	
	☑	sodium chloride 0.9% infusion 250 mL	Every visit	S	Until discont'd	
		250 mL, intravenous, at 30 mL/hr, once, Starting when released
	Administer with blood to keep vein open.		
	☐	sodium chloride 0.9% infusion 500 mL	Every visit	S	Until discont'd	
		500 mL, intravenous, at 30 mL/hr, once, Starting when released
	Administer with blood to keep vein open.		

Post-Medications 	

	
	Interval	Defer Until	Duration	
	☑	sodium chloride 0.9% flush 10 mL	Every visit	S	Until discont'd	
		10 mL, intravenous, PRN, line care, Starting when released, Until Discontinued
	IV flush upon transfusion completion.		
	☐	furosemide (LASIX) injection 20 mg	Every visit	S	Until discont'd	
		20 mg, intravenous, once
	Inject each 20 mg of furosemide slowly IV over 1 to 2 minutes.  Administer after first unit of blood.		
	☐	furosemide (LASIX) tablet 20 mg	Every visit	S	Until discont'd	
		20 mg, oral, once, Starting when released
	Administer post blood transfusion.