Blood Administration Flashcards
Functions of blood
Transports O2 from the lungs, hormones from the endocrine glands, nutrients and fats from digestive system to cells in the body.
Transport CO2 and other waste products formed during metabolic activities of the cells to kidneys, lungs and other organs for removal from the body.
Regulates pH and electrolyte levels of the body for proper cell function
Regulates body temp
Protects from infection WBC and invasion (antibodies)
Composition of blood
55% plasma
45% formed elements
Formed elements
-RBC’s
-WBC’s
-Platelets
Albumin
Aids in keeping the correct amount of water in the water in the blood
Fibrinogen
Needed for blood clotting
Globulins
Form antibodies to help protect from infection
Erythrocytes
-formed in bone marrow
-contain hemoglobin which transports O2 from the lungs to the body’s cells
-help to transport CO2 from cells to lungs for removal
Whites blood cells
Protect from invasion and infection
Neutrophils
The most aggressive
They surround and ingest invaders using lysosomes that release powerful enzymes (phagocytosis)
Eosinophils
Combat parasitic invasion and body irritants that lead to allergies
Basophils
Involved in allergic reaction by enhancing the body’s response to irritants. Also produce heparin
Monocytes
Perform the same function as neutrophils, just take longer to get there and are in larger numbers, therefore able to destroy more bacteria. Usually seen more in chronic or long term infections
Lymphocytes
Unique in the way that they do not use phagocytosis to destroy cells. Instead they form antibodies that inhibit or attach the invaders
Platelets
-thrombocytes
-change fibrinogen into fibrin
A blood type
A antigen
Anti-B antibodies
B blood
B antigen
Anti-A antibodies
AB blood type
A, B antigens
No antibodies
O blood
No antigens
Anti A and Anti B antibodies
What blood type in the universal recipient
AB, they have no antibodies so they can receive all types of blood
What blood type are universal donors
O blood
They have no antigens
What is a transfusion reaction
Occurs when people with Rh- blood receive Rh+ blood
Whole blood
Used in transfusions or broken down into its components and used that way
Packed RBCs
Used for anemia and replacement of traumatic or surgical blood loss
Fresh frozen plasma
Contains all coagulation factors
Used in bleeding problems after trauma or liver transplants
Platelets
Promote blood clotting and wound healing
Albumin
Proteins in the blood
Used in volume replacement
Crycoprecipate
Precipice recovered from thawing frozen plasma between 1 and 6 degrees
Indications for blood admin
-Significant hypovolemia due to acute blood loss
Symptomatic anemia
Decreased hemoglobin
Decreased hematocrit
To increase O2 carrying ability
Decreased clotting factors
Equipment needed for a blood transfusion
-Physician order
-Blood typed and screened and crossed matched
Venous access
Filtered admin set
0.9% NS
Thermometer
What cant you mix blood with
D5W
LR
Medications
What happens if you mix blood with d5W
Causes hemolysis
What happens if you mix blood with LR
Causes clotting
How to prepare the patient
-confirm order
-Check patient for
-right pt
-right blood product
-right type
-vitals
Stable IV access
Transfusion procedure
Flush tubing with NS
Cover the admin filter with blood
Connect blood tubing
Piggy back onto IV line of 0.9NS
Start transfusion slowly
Monitor for reactions
Transfusion rate
Initially @1ml/min
Evaluation for reactions
Monitor vitals q 5min
After 30mins adjust flow
Monitor for reactions
Monitor q 30min
Transfusion rate for whole blood and packed RBCs
2-3hours
No more than 4 hours
Transfusion rate for fresh frozen plasma
Less than 2 hours
S/S of a transfusion reaction
Fever (2 degrees or more)
-hives, itching
-swelling, soreness or hematomas at IV site
Tachycardia
SOB
Hypotension
Anaphylaxis
Blood in urine
Febrile reaction
-rare
-occurs if blood is contaminated by bacteria or virus
Allergic reaction
-rare but most common
People can be allergic to the anticoagulant used in the blood as well as small fragments of WBCs
Wheezing
Sneezing
Hives
Itching
Swelling of throat
Transfusion Related lung injury
-caused by a reaction to white cell fragments and certain antibodies that cannot be filtered out of the blood
Serious side effect that can result in death
SOB, drop in pressure, fever
Transfusion Associated Circulatory overload (TACO)
Usually occurs in the elderly
Rapid/too much fluid admin
Similar symptoms to TRALI
Hemolytic transfusion reaction
-most serious effect
Caused by incorrectly matched blood
Almost always results in death
Symptoms:
Low back pain
Fever
Chills
SOB
Hypotension
Blood in urine
What happens in a hemolytic transfusion reaction
Recipients immune system will destroy transfused RBCs. These are filtered out by spleen, liver, kidneys and cause organ damage
Treatment for a transfusion reaction
-stop transfusion
-check vitals
-maintain IV access
-check to make sure correct blood was given
-save remaining blood products
Notify physcian
Notify transfusion service provider
Transfusion reaction management
-O2
Benadryl/epi/tylenol/lasix
Treat shock symptoms
Collect fresh blood and urine samples for the lab
