Question

8. Describe in detail blood administration set-up and the first hour of the infusion. Include all aspects of safety. 9. Describe SBAR in detail for the floor nurse. 10. You have an 88 year old female patient in with a right total hip arthroplasty who is post op day 1. Your patient's physician orders a dose of pain medication for your patient He orders 6 mg of Dilaudid. Is this a safe dose? Drug Classification? What do you do? Administer or call for clarification?

Answer 1

answer

8. before giving blood transfusion ,we should cross match blood for avoiding immune reaction . If the blood group of donar and recipient is different ,there is chance of immune reaction if we transfuse whole blood to the recipient body.so before transfusing blood to a patient we should check patients details like name ,age ,sex , mrd number ,ward ,bed number, blood group ,whole blood or blood component, blood bank details like blood issue number , date of collection ,expiry date, infectious agents status like hiv ,hbsag ....compatibility status, issued blood group ,time of transfusion started ... has to be written in case sheets with attachment of blood details paper also . even after checking everythings patient may develop immune reactions, symptoms like itching all over body ,rashes,palpitations,breathing difficulty,lip swelling,headache...... in such cases do immediate stoppage of blood transfusion,give inj hydrocortisone 100 mg iv stat, inj avil 1 ampoule im stat , monitor vitals,examine chest and heart, iv fluid normal saline fast stat. monitor the patients for worsening of symptoms and development of shock and manage symptomaticaly.

9. SBAR is an acronym for (Situation,Background,Assessment,Recommendation, ) is  a technique can be used to facilitate prompt and appropiate communication. for communication between members of health care team about a patients condition. nurses have vital role by transferring relevant and critical information. this techniqe helps in focussed and easy communication between nurses especially during transition of patient care from one nurse to another. it is an evidence based best practise communication technique. SBAR was originally developed by u.s navy as a communication technique . example of sbar include phone call between a nurse and physician about a patient.

10. DILAUDID its generic name is HYDROMORPHONE HCL. it is an opioid analgesic , usualy giving for moderate to severe pain .action is in the brain. can be given iv, im ,sc deponds on situation. normaly strength are 0.5 mg/ml , 1mg/ml , 2 mg/ml . usual dose in elderly is 0.2 mg iv . in this situation doctor advised 6 mg of dilaudid,  this is high dose for 88 yr old patient. so before adminstering 6mg dose ,call the doctor for clarification.