2 Flashcards
(104 cards)
which blood product contains all coagulation factors?
FFP
the leading cause of death r/t blood transfusion is?
transfusion associated circulatory overload
more likely to happen to pt that are critically ill
what are disadvantages to storing blood?
-progressive decrease in ATP and 2,3 dpg
-results in L shift
-even though admin of hgb will increase ability of blood to transport oxygen, the longer the blood is stored and the more of it that is given, the ore the pt oxyhgb diissociation curve shifts L -> decreasing effectiveness of the blood given
-K in stored blood increases- can be hazardous when lg doses of blood is admin
the recmmended therapeutic dose of plt concentrate is 1 plt concentrate per
10 kg of body mass
in what pt would be admin of uncrossmatched type o, rh pos blood be contraindicated
uncrossed type o rh pos blood can be adminisered to males or females who are not childbearing age who have never recieved o pos blood before.
if the pt is female child bearing age or if pt blood admin hx is unknown- then you should use o neg blood
when are plt transfusions indicated? when plt count drops below
50,000
what does cryo contain
factor VIII, von williebrand, fibrinecton, and fibrinogen
what is the recommended dose of FFP to reverse the effects of warfarn?
5-8 mL/kg
for all other purposes the dose should be 10-20 mL/kg
what is acute normovolemic hemodilution?
alternative to transfuison. whole blood is removed from the pt prior to surgery with replacement of lost volume in the form of crystalloids or colloids. by diluting vascular bed, any blood lost during surgery will have a lower hct. the previous removed blood is then reinfused back into the patient when intraop blood loss has ceased.
allergic rxns to blood transfusions are mediated by what antibodies
igE and donor plasma proteins
a pt with von williebrand disease is experiencing cont bleeding at the site of his surgical incision despite tx with DDAVP. the next treatment you would recommend for this patient is
cryo. this pt should get desmopressin which increases factor VIII- vWF complex and improves coagulation. if desmopressin doesnt work then cryo should be considered
how much should the hgb increase by 1 unit
1 unit should increase hgb by 1 and hct 2-3
a fully soaked laparotomy sponge will hold about __ mL of blood
100-140 mL of blood
common reasons to give cryo
-von williebrand
-pt with low fibrinogen levels (<80)
what issue would you expect to result from a catastrophic failure of the oxygen first stage regulator?
significant loss of oxygen pressure regardless if it was from the oxygen cylinder or the pipeline
when carbon dioxide absorbent is exhausted, what chemical accumulates in the cannister?
carbonic acid accumulates, turning the indicator dye purple
where are bacterial filters on the machine?
at the y piece- serving as both inspiratory and expiratory filters
which diuretics enhance the reabsorption of calcium in the distal tubule and can potentially result in hypercalcemia?
thiazide type diuretics- enhance reabsorption of ca in distal tubule
what device monitors the integrity of the isolated power supply for an operating room?
line isolation monitor
operating rooms often have an isolated power supply- decrease the incidence of inadvertant electrical shock if a pt or healthcare worker come into contact with a single live wire. unless both power lines are contacted, a circuit is not completed, and the risk for electrical shock is minimized. the presence of a faulty piece of equipment can turn an isolated power supply into a traditional, grounded electrical source, and electrical shock becomes a higher risk.
a line isolation monitor constantly evaluated the integrity of the system to produce an alert if this happens
a drug with a high hepatic extraction ratio exhibits a decreased metabolism in elderly patients primarily due to a decrease in
hepatic blood flow
hepatic transaminase levels and hepatic enzyme activity do not normally change with increased age.
hepatic mass does decrease with age, but clearance of drugs with high hepatic extraction ratio relies on hepatic blood flow not hepatic mass
patients with chronic renal failure tend to exhibit
A. hypokalemia
B. hyperventilation
C. hypophosphatemia
D. hypercalcemia
B. hyperventilation
due to chronic metabolic acidosis and increased predisopsition to pulm edema
if not accompanied with an anticholinergic, the admin of neostigmine can produce
A. paralytic ileus
B. tachycardia
C. salivation
D. bronchodilation
C. salivation
profound PNS effects (bronchospasm, salivation, increased bowel mobility)
vapor pressure of des is __ x that of other contemporary inhaled anesthetics
3-4 x
what does des boil at
22.8 c (slightly above rm temp)
