The nurse is preparing a patient for plasmapheresis. In which order should the nurse complete the following actions?
Choice 1. Check with physician about holding medications.
Choice 2. Assess vital signs and weight.
Choice 3. Verify blood type and crossmatch for replacement blood products.
Choice 4. Assess for dizziness or hypotension.
Choice 5. Assess intravenous port for bruising.
Choice 6. Reevaluate laboratory data, especially CBC, platelet count, and clotting times.
Correct Answer: 1, 2, 3, 4, 5, 6
Check with the physician about holding medications until after the procedure. Medications may be removed from the body as an incidental part of the plasmapheresis process. Assess vital signs and weight. Baseline parameters are necessary to evaluate for fluid imbalances and response to therapy. Check blood type and crossmatch for replacement blood products. Hypersensitivity reactions can occur, and close monitoring is important. During the procedure, assess for dizziness or hypotension due to hypovolemia, which can occur. Hypovolemia is a complication of plasma exchange, especially during the procedure when up to 15% of the patient's blood volume is in the cell separator. After the procedure, assess the intravenous port for signs of bruising. The site of vascular access is at risk for complications and must be routinely and carefully assessed for bleeding or hematoma formation. Reevaluate laboratory data since anticoagulation is part of the procedure. The cell-separating process can damage cells; anticoagulation is part of the procedure.
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