NATIONAL AMERICAN UNIVERSITY BLOOMINGTON CAMPUS BSN PROGRAM Nursing 3360: Holistic Nursing Care in Acute Illness I Spring

2014 Learning Plan 4 Introduction to Hematolo ! and La" Inter#retation Blood Tran$%u$ion$ Ob ecti!e o" t#e Course$Co%petenc&: 1' (e%onstrate t#eoretical principles an) abilit& to per"or% sa"e* e""ecti!e an) e""icient ps&c#o%otor s+ills' &no'led e and $(ill$ leadin to ma$ter! o% t)i$ com#etenc! a* E+#lain t)e interrelation$)i#$ amon t)eor!, #ractice, and re$earc)* "* Inte rate t)eorie$ and conce#t$ %rom li"eral education into nur$in #ractice* c* -etermine t)e a##lication o% #$!c)omotor $(ill$ %or t)e e%%icient, $a%e, and com#a$$ionate deli.er! o% client care* e* Promote re$#irator!, circulator!, cardio#ulmonar!, a$trointe$tinal, enitourinar!, inte ument, and mu$culo$(eletal %unctionin * 2' Ac,uire +no-le)ge t#at pro%otes t#e sa"e )eli!er& o" prescribe) %e)ications' &no'led e and $(ill$ leadin to ma$ter! o% t)i$ com#etenc! a* E$ta"li$) a %oundational under$tandin o% t)e medication admini$tration #roce$$* "* Identi%! $ource$ o% in%ormation nece$$ar! to admini$ter #re$cri"ed medication, includin com#ati"ilit! and interaction$ amon #re$cri"ed medication$ and com#lementar! $u"$tance$* c* -etermine t)e $a%e ran e o% t)e do$a e #re$cri"ed* d* Calculate do$a e nece$$ar! to admini$ter #re$cri"ed medication$* e* -etermine t)e a##ro#riatene$$ o% t)e route %or dmini$tration o% #re$cri"ed medication* %* -emon$trate t)e a"ilit! to #re#are and admini$ter #re$cri"ed medication* * -etermine t)e e%%ecti.ene$$ o% t)e #re$cri"ed medication* )* -emon$trate t)e a"ilit! to %ollo' #rocedure %or 'or(in 'it) controlled $u"$tance$* 3' ./plain t#e purposes* rationales* an) in)ications "or !arious nursing actions' &no'led e and $(ill$ leadin to ma$ter! o% t)i$ com#etenc! a* Incor#orate a model o% critical t)in(in ')en ma(in clinical /ud ment$ and deci$ion$* "* Cite nur$in and a$$ociated literature t)at $u##ort$ t)e nur$in action* c* -eli.er com#a$$ionate, client0centered, e.idence0"a$ed care t)at re$#ect$ client and %amil! #re%erence$* d* E+#lore #)enomena in nur$in t)at relate$ to t)e )uman re$#on$e to illne$$*

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Ac,uire +no-le)ge "ro% t#e be#a!ioral* biological an) p#&sical sciences necessar& to pro!i)e si%ple to inter%e)iate le!el nursing actions' &no'led e and $(ill$ leadin to ma$ter! o% t)i$ com#etenc! a* S!nt)e$i1e t)eorie$ and conce#t$ %rom li"eral education to "uild an under$tandin o% t)e )uman e+#erience "* Identi%! $ource$ o% in%ormation nece$$ar! to deli.er nur$in action$ to client$ and %amilie$ ')o are e+#eriencin illne$$* c* Incor#orate t)eorie$ o% a in ')en #ro.idin care %or erontolo ical client$* d* E+#lore t)e Pattern$ o% &no'in * 0' (ocu%ent pertinent* accurate an) co%plete client care in"or%ation' &no'led e and $(ill$ leadin to ma$ter! o% t)i$ com#etenc! a* Incor#orate a $tandardi1ed terminolo ! in a care en.ironment t)at re%lect$ nur$in 2$ uni3ue contri"ution to #atient outcome$* "* E+amine in%ormation and electronic medical record $!$tem$ u$ed to document client in%ormation* c* E+#lain t)e u$e o% CIS $!$tem$ to document inter.ention$ related to ac)ie.in nur$e $en$iti.e outcome$* 6' (e%onstrate a)!ancing +no-le)ge an) s+ill in i%ple%enting t#e nursing process in client care an) critical t#in+ing acti!ities' &no'led e and $(ill$ leadin to ma$ter! o% t)i$ com#etenc! a* Articulate t)e com#onent$ o% t)e nur$in #roce$$4 A$$e$$ment, dia no$i$, outcome identi%ication, #lannin , im#lementation, and e.aluation* "* Relate t)e $i+ com#onent$ o% t)e nur$in #roce$$ to t)e nur$e2$ clinical rea$onin * c* -i$cu$$ t)e $i ni%icance o% nur$in dia no$i$ %or nur$in #ractice* d* -i%%erentiate "et'een a medical and nur$in dia no$i$* e* -i$cu$$ t)e cate ori1ation o% nur$in dia no$i$ "! %unctional )ealt) #attern$* %* E+#lore t)e %our t!#e$ o% dia no$tic $tatement$4 Actual, ri$(, #o$$i"le, and 'ellne$$* * E+#lain t)e #ur#o$e$ o% outcome identi%ication and #lannin * )* E+#lore Nur$in Outcome$ Cla$$i%ication$ and Nur$in Inter.ention Cla$$i%ication* i* E+#lain t)e #ur#o$e$ o% im#lementation and e.aluation* /* E+#lain acti.itie$ t)e nur$e carrie$ out to e%%ecti.el! u$e t)e nur$in #roce$$* 1' ./plore t#e stress* an/iet&* coping an) a)aptation o" t#e client an) "a%il&' &no'led e and $(ill$ leadin to ma$ter! o% t)i$ com#etenc! a* In.e$ti ate t)e conce#t$ o% $tre$$, an+iet!, co#in and ada#tation* "* E.aluate #er$on en.ironment %actor$ t)at contri"ute to t)e e+#erience o% $tre$$ and an+iet!* c* E+amine t)e im#ortance o% co niti.e a##rai$al in e+#eriencin $tre$$* d* -etermine $trate ie$ to mana e $tre$$ and illne$$* e* -etermine ')en #ro"lem0%ocu$ed and emotion0%ocu$ed co#in $)ould "e u$ed* O!er!ie-: Blood admini$tration i$ %re3uentl! u$ed %ollo'in man! t)era#eutic and $ur ical #rocedure$* Ho'e.er, it onl! i$ a tem#orar! mean$ o% $u##ort until t)e underl!in #ro"lem )a$ "een

re$ol.ed* Blood tran$%u$ion$ re%er to #latelet$, #ac(ed red "lood cell$ 5PRBC$6, or #la$ma* Blood tran$%u$ion$ )a.e man! #otential )a1ard$7 t)ere%ore, t)e! $)ould onl! "e u$ed i% nece$$ar!* T)e nur$e mu$t en$ure t)at t)e ri$($, "ene%it$, and alternati.e$ o% "lood com#onent t)era#! )a$ "een t)orou )l! di$cu$$ed and a 'ritten con$ent %orm $i ned and #laced in t)e #atient2$ medical record #rior to admini$tration o% "lood com#onent$* Learning Acti!ities: Le-is: C)a#ter 89 Hematolo ical S!$tem A2I A)ult 3e)ical4 Surgical Nursing: C)a#ter :8 Hematolo ic -ia no$tic Procedure$ 5e!ie-: Co%e to Class Prepare) to (iscuss: Hematolo ! and La" Inter#retation o Blood com#onent$ o Clottin o La"orator! $tudie$4 CBC ESR Blood t!#in and R) %actor S!$tem $#eci%ic la"$4 Cardiac mar(er$ Li.er %unction te$t$ Renal te$t$ T)!roid Blood tran$%u$ion$ o Indication$ o T!#e$ o% tran$%u$ion$ o Monitorin "e%ore, durin , and a%ter tran$%u$ion o Com#lication$ Post4class4 Blood Tran$%u$ion ;or($)eet 5attac)ed6 Learning Ob ecti!es: <* -i%%erentiate "et'een t)e di%%erent t!#e$ o% "lood cell$ and t)eir %unction$* =* -e$cri"e t)e $u"/ecti.e and o"/ecti.e a$$e$$ment data related to t)e )ematolo ic $!$tem t)at $)ould "e o"tained %rom a #atient* 8* -e$cri"e t)e com#onent$ o% a #)!$ical a$$e$$ment o% t)e )ematolo ic $!$tem* :* -i%%erentiate normal %rom common a"normal %indin $ o% a #)!$ical a$$e$$ment o% t)e )ematolo ic $!$tem*

>* -e$cri"e t)e #ur#o$e, $i ni%icance o% re$ult$ and nur$in re$#on$i"ilitie$ related to dia no$tic $tudie$ o% t)e )ematolo ic $!$tem* ?* Blood tran$%u$ion$ a* Indication$ "* T!#e$ o% tran$%u$ion$ c* Monitorin "e%ore, durin , and a%ter tran$%u$ion d* Com#lication$ @* -e$cri"e t)e nur$in mana ement o% t)e #atient recei.in tran$%u$ion$ o% "lood and "lood com#onent$*

BLOOD REPLACEMENT
1. List 3 objectives for blood transf sion.

!. Define t"e follo#in$ ter%s a. A$$l tinin b. Anti$en c. A tolo$o s donor d. ABO e. R" 3. T"e niversal donor "as t"e blood $ro & ''''''''''''''''''''. (. T"e blood $ro & of t"e niversal reci&ient is ''''''''''''''''''. ). T"e n rse % st c"ec* #"ic" of t"e follo#in$ #it" anot"er n rse before initiatin$ t"e transf sion+ a. ABO and Rh b. Patient name. c. Unit number on compatibility tag. d. Expiration date. e. All of the above. ,. T"e reco%%ended rate of inf sion for a nit of #"ole blood or &ac*ed RBC-s is ''''''' "rs. b t not lon$er t"an ''''''''''"rs. /. Clients &artic larl0 at ris* for circ lator0 overload are (name three) '''''''''''''''. 1. Needle si2e for blood transf sion is 3'''''''' to 3'''''''''''' $a $e. 4. 5nf sion for blood % st al#a0s "ave ''''''''''''' and a ''''''''''' ad%inistration set. 16. T"e client is &artic larl0 at ris* for a transf sion reaction d rin$ t"e first 1) %in tes. List n rsin$ action 0o #ill do to %onitor t"e client for si$ns7s0%&to%s of a reaction. 11. List ) si$ns and s0%&to%s %ost co%%onl0 associated #it" transf sion reaction.

1!. 58 t bin$ s"o ld al#a0s be &ri%ed #it" #"ic" 58 sol tion+'''''''''''. 9"0+

13. N rsin$ actions for blood transf sion reaction: