Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

N206 Final > Blood Administration > Flashcards

Blood Administration Flashcards

1
Q

Benefits to Blood management

A
  1. Improves patient outcomes
  2. Lessens exposure to infection
  3. Facilitates faster recovery
  4. Decreases post operative infection rates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Blood transfusion is?

A

the replacement of blood or blood components when O2 delivered to the tissue is compromised.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

blood and blood products are used to?

A
  1. Improve or restore oxygen carrying capacity & tissue oxygenation
  2. Restore blood volume lost d/t trauma, haemorrhage, surgery, and burns etc.
  3. Correct red blood cell deficiency
  4. Maintain or improve blood’s clotting ability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Components of whole blood:

A
  1. Concentrated Red Cells
  2. White cells
  3. Plasma (proteins, globulins, albumin)
  4. Platelets
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Non Fractionated Blood Products

A
  1. Red Blood Cells
  2. Fresh Frozen Plasma
  3. Platelets
  4. Cryoprecipitate
  5. Autologous Whole Blood- where the PTs whole blood is injected into places to help healing/clotting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Fractionated Blood Products

A
  1. Immune Globulin- antibodies Y
  2. Albumin- in blood plasma. Proteins that reg blood vol
  3. Factor Concentrations- clotting factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Albumin

A

> Red Blood Cells

> Fresh Frozen Plasma- fluid portion of blood. Contains components of : coagulating factors, oncotic pressure and modulate immunity

> Platelets- stop bleeding

> Cryoprecipitate- frozen blod product prepared from plasma. clotting factors

> Autologous Whole Blood- process where PTs own blood is injected into an area of the body for the purpose of healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pentaspan

A
  1. plasma expander
  2. synthetic cornstarch derivative in saline solution
  3. no risk of disease transmission
  4. 1.5 x greater vol expander than albumin with longer duration of expansion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

blood group O

A

is a universal donor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

blood group AB

A

is a universal recipient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Rh factor

A

> antigen D is an inherited antigen in the surface of RBCs
ppl with antigen D are Rh+
ppl without are Rh -
exposure to antigen D is necessary for production of Rh antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If the reciepient blood cell antigen is not compatible with the donor cell antigen,

A

a reaction called agglutinin (antibody)

> antibodies destroy or neutrilize antigens by clumping (agglutination) YYYyyYyY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Massive blood transfusions

A

> PRBCs are deficient in clotting factors & platelets

> Calcium binds with preservatives in PRBCs

> For these reasons, FFP, platelets, calcium and cryoprecipitate are given to patients receiving massive blood transfusions.

> Rule of thumb – for every three units of PRBCs the patient is given 1 FFP and 1 bag of platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

General rule of thumb for blood and blood prod admin

A

> Written consent is required to administer non-fractionated blood products (2 nurses needed to check)

> RN, RPN, Physician & LPN may check fractionated blood products without a second person.

> No Medication may be added to the blood or infused through the same tubing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Transfusion reactions:

A

A systemic response to the administration of a blood product that is either incompatible with that of the recipient, contains allergens to which the recipient is sensitive or is contaminated with bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Most common occurance of transfusion reaction is d/t:

A
  1. admin errors. incompatible blood

2. misidentification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Types of blood transfusion reactions

A
  1. Acute hemolytic - chills, rigors, dyspnoea, chest and/or flank pain, discomfort at infusion site, sense of dread, abnormal bleeding
  2. Febrile, non hemolytic (most common) > 38 degress or 1 degree above baseline. Chills, rigors, increased respiratory rate, change in blood pressure, anxiety and a headache
  3. Mild allergic- hives (urticarial), upper resp, N/V, abd pain
  4. Anaphylactic- sudden onset of severe hypotension, cough, bronchospasm (respiratory distress and wheezing), laryngospasm, angioedema, urticaria, nausea, abdominal cramps, vomiting, diarrhoea, shock and loss of consciousness. This may be a fatal reaction.
  5. Circulatory Overload- dyspnoea, orthopnea(SOB lying flat), cyanosis, tachycardia, increased blood pressure and pulmonary edema
  6. Sepsis- high fever, rigors (shiver), hypotension, tachycardia, N/V,

Know your signs and symptoms associated with each type of transfusion reaction!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

recognizing transfusion reactions

A

Rash, Pruritis

Headache, flushing, back pain, chest pain

Fever (oral T more than 38 and more than 1 degree rise above baseline)

Rigors, restlessness, anxiety, facial or tongue swelling, dizziness, nausea/vomitting

Heat/pain at IV site, hypertension, hypotension, tachycardia

Dyspnea, wheezing, hypoxia and oliguria

19
Q

Immediate interventions for transfusion reactions:

A
  1. Stop transfusion & disconnect at site
  2. Run 0.9% NS via new tubing
  3. Verify pt’s ID band to blood product tag
  4. Check VS and symptoms
  5. Notify physician and transfusion services
  6. Complete transfusion reaction form and any follow up investigation of the reaction
20
Q

a PT recieves a transfusion of RBCs that is their own which they donated prior to surgery

A

autologous blood transfusion

21
Q

Recieving a transfusion of RBCs from an anonymous donor

A

homologous donor

22
Q

determining the ABO and Rh compatibility of the donor and recipient prior to transfusion

A

a cross match

23
Q

a marker that identifies a cell as “self” or non-self”

A

an antigen

24
Q

a complex glycoprotein produced in response to the presence of an antigen

A

an antibody

25
Q

RBC, WBC, plasma, platelets, are:

A

a component of whole blood

26
Q

cryoprecipitate

A

is a component of plasma

27
Q

platelets are pooled from ____ donors

A

5

28
Q

Cryoprecipitate is obtained from:

A

FFP (fresh frozen plasma) rich in factor 8 (blood clotting protein) and fibrinogen

29
Q

ppl with antigen D are:

A

Rh +

30
Q

ppl with O type can recieve

A

only O

31
Q

if you have antibodies AB in your plasma then

A

you have type O

32
Q

if you have no antibodies in your plasma then

A

you have type AB

33
Q

why is O the universal donor?

A

bc they do not have AB antigents

34
Q

when do we use blood and blood products?

A

to improve PT outcomes, lessen their chance of post-op infections, and optimize recovery time.

35
Q

when would we choose to use albumin over PRBCs?

A

when the PT has CHF and is at risk for fluid overload and thier hemoglobin is high enough to support their O2 carrying capability

36
Q

admin of blood and blood products is done for what purpose?

A

to restore circulating blood vol, improve O2 carrying capacity, and replace clotting factors

37
Q

25% albumin in hyperoncotic (osmotic pressure) - if you give 100mls, then what would you expect to happen to your PTs extravascular fluid

A

it will pull aprox 300mls of fluid from the extravascular

38
Q

name two types of transfusion reactions you need to watch for

A
  1. Allergic
  2. Febrile
  3. circulatory overload
  4. hemolytic reaction
  5. TRALI- transfusion related acute lung injury
39
Q

admin of incompatible blood or a rare antibody causes a hemodynamic blood reaction. name 4 signs and symp which indicate a hemodynamic blood reaction

A
  1. ha
  2. flushing
  3. lumbar pain
  4. pain
  5. chills
  6. fever
  7. burning sensation
  8. sensation along vein
  9. angina like chest pain
40
Q

Allergic reaction are more common d/t the presence of some protein in donor blood that is foreign to the recipient and to which the recipient is allergic. What are 2 S and S of allergic reaction?

A
  1. Urticarcia- hives
  2. elevated temp
  3. pruritits
  4. ha
  5. epigas pain
  6. nausea
41
Q

why would your PT experience circulatory overload and what would be the S and S?

A

from rapid admin for large amounts of blood product especially in the elderly and infants

s and s- chest tight, dry cough, engorged neck muscles, dyspnea, pulm edema, frothy pink sputum, tachycardia and hypertension

42
Q

what are two common reasons for transfusion reaction?

A

incorrect PT

admin of incompat blood

43
Q

Steps of blood admin

A

> verify doc order- amount and type. date, pre and post med orders r/t transfusion

> be sure informed consent

> obtain pt transfusion hx

> inform PT of tx and rationale

> obtain aprop expipment

> ensure IV acess with NS is running in primary line. ensure that IV needle canula is 18-20 gauge

> ensure any necessary PT prep. has the PT peed prior, pain manage?

> obtain blood from Transfusion Service (TS)

    • bring doc identifying PT and prod required (doc orders…)
    • verify info on blood bag tag with info TS personnel**

**If blood not initiated within 30 min it has to be returned to TS

> obtain vitals, temp, immediate bfr trans.

> varify if non-factionated blood and blood products by 2 qualified personelle (doc, RN, LPN, Perfusionist) AT THE BEDSIDE (all frac blood products are to be verifies by one qualified person), IN PTs PRESENCE

    • confirm product serial number and ABO/Rh from the identification label on the product matches the blood product tag.
    • visual inspect the blood for color, clump. leak

> verify PT ID with the blood prod by 2 qualified personnel AT THE BEDSIDE, IN THE PT PRESENCE.

    • have PT spell first and last name if poss and DOB to confirm with ID band
    • read aloud and spell PTs full name and PTs hosp number from the Id band. ensure identical to blood product tag

> doc info on the FHA blood prod admin record

> admin the blood product

a) gently rotate bag several times and insert spike of blood admin set and prime
b) ensure filter is completely covered with product to maximize effeciency of filter
c) remove primary IV set and connect blood tubing to PT. Open roller clamp and adjust the flow rate to infuse slowly; maximum of 25ml in the first 15min (100ml/hr).
d) document start time on blood prod admin record

> assess

    • remain with the PT for a full 5 min to observe SE.
    • check vitals, 15 after initiating transfusion and hrly throughout transfusion.

> adjust flow rate so that blood flows no longer than 4 hrs. but 2 hrs is more ideal

> upon completion of transfusion,

a) clear blood admin set with a max of 50mls NS
b) obtain PTs vital signs
c) disconnect blood admin set and attach ordered IV tubing/bag

> remove and complete blood prod tag and return to TS

> discard the blood bag in apporp biohazard container unless the PT has had a transfusion reaction. If reaction, then all gear ahd to go to TS

> doc the completion of admin on the following:

a) blood prod admin record
b) blood prod tag
c) fluid balance sheet
- -> date and time
- -> type and amount of blood prod. If no vol, record vol as 350mls for RBC and 200mls for plasma

d) nurses notes- baseline vitals, transfusion start ,and completion time, observations throughout, completion vital signs

e) clinical record
- - vital signs, temp

> assess vital signs for delayed transfusion reaction q4h x 24 hrs

N206 Final (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions