MUFULIRA SCHOOL OF NURSING

CLINICAL LESSON PLAN

COURSE TITLE : FUNDAMENTALS OF NURSING

LESSON TOPIC : BLOOD TRANSFUSION

STUDENT : BWALYA MUNJILI

COMPUTER NO : FNMS 0112/12

SUPERVISOR : MRS NACHALWE

TARGET GROUP : 2 nd YEAR STUDENTS

CLASS SIZE : 53 STUDENTS

DATE : 26/02/2014

TIME REQUIRED : 1 HOUR

VENUE : MAIN CLASSROOM

TEACHING METHOD : DISCUSSION AND DEMOSTRATION

AUDIOVISUAL AIDS: Trolley; 2 trays; 3 galipots; cotton wool swabs ; antiseptic solution; blood giving set; cannula;
tourniquet; adhesive tape; fluid balance chart; blood; normal saline; 3 receivers; splint; mackintosh; dressing towel; thermometer;
sphygmomanometer; stethoscope;

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General Objective:

At the end of the discussion and demonstration, the students should be able to show knowledge and skill in setting up for and
administration of blood transfusion for a patient that requires transfusion.

Specific Objectives:

1. Define blood transfusion.

2. List the indications for blood transfusion.
3. Mention the principles of blood transfusion.
4. Mention the requirements for blood transfusion.
5. Mention the complications of blood transfusion.
6. Demonstrate the procedure of blood transfusion.

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Time Specific Content Teaching AVA Teacher’s Student’s Evaluation
Objective Method activity activity

10 Introduction Discussion Explaining, Listening,

minutes asking and answering
Blood transfusion replenishes both answering questions,
the volume and the oxygen carrying questions. taking notes.
capacity of the circulatory system.
Blood for transfusion is obtained from
a healthy donor or donors whose
ABO blood group and antigenic
subgroups match those of the
recipient and who have an adequate
hemoglobin level.

Blood collected from a donor is stored

in a plastic bag containing citrate-
dextrose or citrate-phosphate. It is
kept in the refrigerator for at least 3
weeks. The blood is removed from
the refrigerator no more than
30minutes before transfusion and is
checked according to the hospital
policy.

The nurse prepares the required

equipment and venipuncture site,
observes the patient during and after
transfusion, and instructs the patient
to report any symptoms associated

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 with the procedure.

5 Define blood Definition of blood transfusion Discussion Explaining, Listening, What is blood
minutes transfusion. asking and answering transfusion?
It is the administration of whole blood answering questions,
or a component, such as packed red questions. taking notes.
cells, to replace blood lost through
trauma, surgery, or disease
(Anderson, 1994)

Transfer of blood of one person into

blood vessels of another
(Thomas,1973 )

5 List the Indications Discussion Explaining, Listening, What are the

minutes indications for asking and answering indications for
blood Blood transfusion is indicated in answering questions, blood
transfusion. clients with: questions. taking notes. transfusion?
1. Hemorrhage
2. Anemia
3. Blood dyscrasias, or
4. Have undergone surgical
procedures

5 Mention the Principles Discussion Explaining, Listening, What are the

minutes principles of asking and answering principles for
blood 1. Ensure that blood is screened answering questions, blood
transfusion. for compatibility questions. taking notes. transfusion?
2. Observe aseptic technique
during administration
3. Check the vital signs as
baseline data.

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 4. If any adverse reaction, stop
blood transfusion.

10 Mention the Requirements Discussion Trolley, 2 trays, 3 Explaining, Listening, What are the
minutes requirements and galipots, cotton wool asking and answering equipment
for blood Trolley demonstration swabs, antiseptic answering questions, needed for
transfusion. solution, blood giving questions. taking notes. blood
Top shelf: Tray containing:
set; cannula; transfusion?
 galipot with cotton wool swabs tourniquet, adhesive
 galipot with antiseptic solution tape, fluid balance
for cleaning the skin chart, blood, normal
 blood giving set saline, 3 receivers,
 cannula splint, mackintosh,
 tourniquet dressing towel,
 adhesive tape thermometer,
 fluid balance chart sphygmomanometer;
 blood stethoscope;
 normal saline
 receiver for dirty swabs
 receiver for draining the
solution infusion
 splint
 mackintosh with dressing
towel

Bottom shelf: Tray containing:

 Thermometer
 Sphygmomanometer
 Stethoscope
 Swabs in a galipot/receiver

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 Preparations

1. Ordering blood: when

transfusion is required a
specimen of the patient’s
blood is sent to the laboratory
with a complete request form
for blood transfusion, which is
filled in by the doctor.
2. Storage of blood: this is
done in the blood bank until
required in the ward or
[Link] must be stored
exclusively in the blood bank
or special refrigerator, which
is controlled at 4 - 6 degrees
celcious. Blood must be kept
at room temperature for not
more than 30 minutes on any
occasion. Blood must must be
warmed and the bottles
should not be shaken. It
should be kept at room
temperature for atleast 20 –
30 minutes, except in
emergency cases when it can
be given soon after removing
from the refrigerator. If blood
is frozen it can be lethal. And
if it is allowed to become
warm, the few organisms
usually present in the bottle

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 will multiply and such infected
blood can also be lethal.
3. Checking of blood: two
Nurses should check all
details, one of which must be
a qualified Nurse.
 Full name of client
 Hospital number
 Name of ward
 ABO blood group
 Rhesus factor
 Expiry date

20 Demonstrate Getting Ready: Discussion Trolley, 2 trays, 3 Explaining, Listening, How is blood
minutes the procedure and galipots, cotton wool asking and answering transfusion
of blood 1. Wash hands and dry them demonstration swabs, antiseptic answering questions, done?
transfusion. with a towel solution, blood giving questions. taking notes.
2. Greet client respectfully and set; cannula;
with kindness tourniquet, adhesive
3. Introduce yourself and explain tape, fluid balance
the procedure to the client chart, blood, normal
4. Obtain consent to carry out saline, 3 receivers,
the procedure splint, mackintosh,
5. Assess client’s needs and dressing towel,
meet them accordingly thermometer,
6. Make client comfortable and sphygmomanometer;
provide privacy by screening stethoscope;
the bed
7. Prepare necessary equipment
and requirements

Actual Procedure:

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 8. Collect blood and ensure that
it is infused within 30 minutes
of removal from laboratory
9. Check the client’s personal
profile with the cross matched
laboratory form
10. Let another senior person in
the ward counter check the
client’s laboratory profile
before blood transfusion
11. Check the vital signs before
commencement of blood
transfusion
12. Insert the mackintosh and
towel beneath the site chosen
for transfusion
13. Hang the infusion equipment
14. Wash hands and wear gloves
15. Apply the tourniquet and
insert cannula
16. Flush the blood giving set with
0.9% normal saline, connect
the rest of infusion and secure
the apparatus with adhesive
tape and splint
17. Calculate drops per minute
according to the doctor’s
orders and regulate the rate of
flow
18. Record observations every 5
minutes for the first 15
minutes then ¼ hourly vital

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 signs for the first hour of blood
transfusion and increase
intervals thereafter between
observations.
19. Commerce transfusion if all
these are in order and not
present e.g. restlessness,
sweating, heart palpitations.
20. Instruct patient to report any
abnormality.
21. Also observe the general
condition throughout and one
hour after transfusion

22. Leave a small amount of

blood in transfusion bag and
return to the blood
bank/laboratory
23. After the blood has been
transfused, infused normal
saline until blood giving set is
clear.

24. Record the observation

25. Clear away equipment,
decontaminate, and store
away
26. Thank and leave client
comfortable; provide
appropriate IEC
27. Record and report to the in-

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 charge

Summary

The procedure for blood transfusion requires particular attention from the nurse administering the transfusion. Blood from the
laboratory must be kept cooled and be transfused within the given time of transfusion.

Assignment

State atleast 10 adverse effects of blood transfusion?

REFERENCES

1. Kenneth N. Anderson et al (1994), Mosby’s Medical Dictionary, 4th Edition, Mosby, Missouri USA

2. Clayton L. Thomas et al (1973), Taber’s Cyclopedic Medical Dictionary, F.A. Davis Co. USA

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3. General Nursing Council of Zambia, (2010), Registered Nursing Procedure Manual, GNC, Lusaka

4. Stanley Loeb et al (1992), Nursing Procedures, Springhouse Coorperation,Pennsylvania

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