You are caring for a 36 year old who was diagnosed with a gastrointestinal (GI) bleed. He is alert and oriented. NKDA. He is not on medications at home, but
has been taking aspirin for minor aches and pains. His chief complaint today is that he feels so tired. His CBC results came back. His hemoglobin and
hematocrit are low and the physician has ordered to transfuse one unit of packed red blood cells (PRBC).
- What additional information do you need?
- What steps would you take to ensure hypervolemia does not occur?
- Explain the steps you would take to administer the unit of PRBC.
- What education would you provide to the patient when he askes why he is getting O+ blood when he is AB+?
- Explain the 5 transfusion reactions you will be monitoring for.
- Identify actual nursing diagnoses related to the GI bleed. (NANDA nursing diagnosis that relates to the patient and disease/problem process. Includes all
parts of the nursing diagnosis, ie: related to ….., as evidence by ….)
- Develop a goal/outcome for the nursing diagnoses.(Nursing goal outcome follows the mnemonic SMART)
- Develop 3 nursing interventions with rationales to help the patient meet the goal/outcome
Sample Solution
