Blood and blood products

Question 1

What are the components of blood which may be filtered out of whole blood to be transfused?

Answer 1

Red Blood Cells
White Blood Cells
Platelets
Fresh Frozen Plasma
Factor Concentrates (clotting factors)
Albumin

Question 2

What are PRBCs?

Answer 2

Whole blood without the volume

Question 3

For what would one be given PRBC?

Answer 3

Chronic anemia

Question 4

What are WBCs?

Answer 4

Granulocytes?

Question 5

For what would one be given WBCs?

Answer 5

To fight infections

Question 6

What are platelets?

Answer 6

Protein for clotting

Question 7

For what would one be given platelets?

Answer 7

Thrombocytopenia

Question 8

What are factor concentrates?

Answer 8

Cryoprecipitate (fibrinogen, vWF, factor VIII and IX)

Question 9

For what would one be given factor concentrates?

Answer 9

Factor VIII deficiency (low platelets with active bleeding)

Question 10

What is FFP?

Answer 10

Fresh frozen plasma

Question 11

For what would one be given FFP?

Answer 11

Active bleeding
(Requires ABO compatibility)
Frequently seen in people getting multiple units of PRBC

Question 12

What is albumin?

Answer 12

Plasma protein

Question 13

For what would one be given albumin?

Answer 13

To retore intravascular volume

Question 14

What antigens and antibodies are present in each type of blood

Answer 14

A - A antigen, anti-B antibodies
AB - A and B antigen, no A or B antibodies
O - no antigen, anti-A and anti-B antibodies

Question 15

What is the Rh factor?

Answer 15

D antigen on the surface of the erythrocyte
Positive = D antigen present
Negative = D antigen absent

Question 16

What to anti-D antibodies form?

Answer 16

Only when Rh negative blood is exposed to Rh positive cells

Leads to agglutination

Question 17

What is given and when to prevent clotting from D-factor?

Answer 17

RhoGAM during 28th week of pregnancy

Given is mother is D- and father is D+

Question 18

What is included in the blood product administration checklist?

Answer 18

CONSENT
Order
History (have you received blood before? Did you have a reaction to it?)
2nd licensed personnel
Tubing/fluid/needle gauge

Question 19

How long is blood viable?

Answer 19

30 minutes upon being received on the unit

Question 20

How large should the bore be for a blood transfusion?

Answer 20

Larger than 20g

Question 21

What is the process of hanging blood?

Answer 21

Hang with saline
Set up the blood
Stay with pt for the first 15 min, doing vitals every 5 min
Proceed to take vitals every 15 min until the first hour is complete, then every hour until the blood is taken down

Question 22

How long is type and screen blood viable for?

Answer 22

3 hours because it will clot

Question 23

What are 6 transfusion reactions/complications?

Answer 23

Febrile Reaction
Allergic Reaction
Hemolytic reaction
Transfusion-Related Lung Injury
Circulatory Overload
Septic Reactions

Question 24

What are symptoms of a febrile reaction?

Answer 24

Fever
Chills
Headache
Malaise

Question 25

How can you prevent a febrile reaction?

Answer 25

Administer antipyretics prior to blood administration

Question 26

What type of blood will a pt receive if they have a history of febrile reactions?

Answer 26

Leukocyte reduced blood

Question 27

What are symptoms of an allergic reaction to blood?

Answer 27

Flushing Urticaria Wheezing Rash with itching

Question 28

How can you prevent an allergic reaction?

Answer 28

Administer antihistamine prior to blood administration

Question 29

What type of blood will a pt receive if they have a history of allergic reactions?

Answer 29

Washed RBCs or platelets

Question 30

What are symptoms of a hemolytic response to blood?

Answer 30

``` Immediate facial flushing Fever Chills Headache *Lower back pain (resulting from lysed RBC trying to get filtered through kidneys) Tachycardia Dyspnea Hypotension Blood in urine *Medical emergency ```

Question 31

What causes a hemolytic reaction?

Answer 31

Incompatible blood | Hemolysis and destruction of blood cells results in clumping and occlusion of capillaries

Question 32

What are symptoms of transfusion-related lung injury (TRALI)?

Answer 32

``` Dyspnea Hypotension Fever 30 min-6 hours after transfusion Diffuse chest infiltrates on x-ray *Medical emergency* ```

Question 33

What is the #1 cause of patient death related to blood infusion?

Answer 33

TRALI

Question 34

Who experiences circulatory overload?

Answer 34

Older people | People with respiratory/cardiac issues

Question 35

How can you prevent a septic reaction?

Answer 35

Inspect blood when it comes up | Feel package with fingers and make sure nothing feels clumpy

Question 36

How should you respond if the patient experiences any adverse reaction?

Answer 36

Stop blood infusion Maintain IV with normal saline Notify provider/blood bank