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NCLEX > BLOOD COMPONENT THERAPY > Flashcards

BLOOD COMPONENT THERAPY Flashcards

1
Q

PACKED RED BLOOD CELLS - REACTIONS AND CONSIDERATIONS

A
  • REACTIONS LESS COMMON THAN WITH WHOLE BLOOD
  • COMPANION SOLUTION = 0.9% NaCl
  • GIVE OVER 2-4HR
  • USE WITHIN 4 HR MAX
  • USE STANDARD BLOOD FILTER
  • GIVEN WHEN LOW HEMOGLOBIN AND LOW HEMATOCRIT
  • > 7 = DEADLY, SHOCK
  • 1 UNIT PRBC = INCREASE HEMOGLOBIN LEVELS BY 1
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2
Q

PLATELETS - REACTIONS AND CONSIDERATIONS

A
  • SOME FEBRILE REACTIONS
  • COMPANION SOLUTION - 0.9% NaCl
  • NON-WETTABLE FILTER
  • GIVE AS QUICKLY AS POSSIBLE, 4 UNITS/HR
  • USE WITHIN 30 MINS MAX
  • HELPS WITH CLOTTING
  • > 150,000 = THROMBOCYTOPENIA
  • > 50,000 = DEADLY
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3
Q

FRESH FROZEN PLASMA - REACTIONS AND CONSIDERATIONS

A
  • CIRCULATORY OVERLOAD RISK
  • ADMINISTER WITH STRAIGHT LINE SET
  • GIVE AS QUICKLY AS POSSIBLE (COAGULATION FACTORS BECOME UNSTABLE)
  • USE WITHIN 60 MINS MAX
  • CLOTTING FACTORS, ENSURES CLIENTS DO NOT BLEED OUT
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4
Q

ALBUMIN - REACTIONS AND CONSIDERATIONS

A
  • POSSIBLE CIRCULATORY OVERLOAD
  • USE ADMINISTRATION SET PROVIDED 25% ALBUMIN - GIVE AT 1mL/MIN
  • GIVE AS QUICKLY AS POSSIBLE IF CLIENT IN SHOCK
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5
Q

PROTHROMBIN - REACTION AND CONSIDERATIONS

A
  • HEPATITIS RISK GREATER WITH WHOLE BLOOD
  • ALLERGIC/ FEBRILE REACTIONS
  • USE STRAIGHT LINE SET
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6
Q

FACTOR VIII - REACTIONS AND CONSIDERATIONS

A
  • ALLERGIC AND FEBRILE REACTIONS
  • USE COMPONENT DRIP SET OR SYRINGE
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7
Q

WHAT ARE THE COMPATIBILITY OF BLOOD GROUPS (A,B,AB,O) - DONOR AND RECEIVE

A
  1. O = DONOR - O, A, B, AB. RECEIVE - O.
  2. A = DONOR - A, AB. RECEIVE - A, O.
  3. B = DONOR - B, AB. RECIEVE - B, O.
  4. AB = DONOR - AB. RECEIVE - AB, A, B, O.
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8
Q

WHAT EQUIPMENT DO YOU NEED FOR BLOOD COMPONENT THERAPY?

A
  1. BLOOD/ BLOOD PRODUCTS
  2. TUBING WITH FILTER
  3. 18- OR 20 GUAGE NEEDLE FOR VENOUS ACCESS
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9
Q

WHAT CHECKS SHOULD YOU UNDERTAKE WITH 2 NURSES?

A
  1. ASK CLIENT ABOUT ALLERGIES OR PREVIOUS BLOOD REACTIONS.
  2. CHECK BLOOD FOR BUBBLES, DARK COLOUR, OR CLOUDINESS.
  3. HEALTHCARE PROVIDER’S ORDER
    4.CLIENT’S IDENTITY
  4. HOSPITAL ID BAND NAME AND NUMBER
  5. BLOOD COMPONENT TAG NAME AND NUMBER
  6. BLOOD TYPE AND Rh.
  7. CLIENTS VITAL SIGNS
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10
Q

WHAT STEPS SHOULD YOU TAKE IS TRANSFUSION REACTION IS SUSPECTED?

A
  1. STOP BLOOD/ BLOOD PRODUCT
  2. RESTART NORMAL SALINE.
  3. CHECK VITAL SIGNS.
    SAVE BLOOD CONTAINER AND TUBING AND RETURN TO BLOOD BANK.
  4. DRAW BLOOD SAMPLE FOR PLASMA, HEMOGLOBIN, CULTURE, RETYPING
  5. COLLECT URINE SAMPLE AND SEND TO LAB FOR HEMOGLOBIN DETERMINATION
  6. MONITOR URINE FOR HEMATURIA.
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11
Q

DISCUSS ALLERGIC REACTION HYPERSENSITIVITY

A

CAUSE: HYPERSENSITIVITY TO ANTIBODIES IN DONOR BLOOD
SYMPTOMS: OCCURS IMMEDIATELY OR WITHIN 24 HR. MILD - URTICARIA, ITCHING, FLUSHING. ANAPHYLAXIS - HYPOTENSION, DYSPNEA, DECREASED OXYGEN SATURATION, FLUSHING.
CONSIDERATIONS: PRE-MEDICATE WITH ANTIHISTAMINES, STOP THE TRANSFUSION, RESTART THE 0.9% NaCl, NOTIFY HCP. SUPPORTIVE CARE - DIPHENHYDRAMINE, O2, CORTICOSTEROIDS.

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12
Q

DISCUSS ACUTE INTRAVASCULAR HEMOLYTIC REACTION

A

CAUSE: INCOMPATIBILITY
SYMPTOMS: OCCURS WITHIN MINS TO 24 HRS. NAUSEA, VOMITING FEVER, PAIN IN LOWER BACK, HYPOTENSION, INCREASE IN PULSE RATE, DECREASE IN URINARY OUTPUT, HEMATURIA.
CONSIDERATIONS: STOP THE TRANSFUSION. SUPPORTIVE CARE: O2, DIPHENHYDRAMINE, AIRWAY MANAGEMENT.

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13
Q

DISCUSS FEBRILE NON-HEMOLYTIC REACTION (MOST COMMON)

A

CAUSE: ANTIBODIES TO DONOR PLATELETS OR LEUKOCYTES.
SYMPTOMS: OCCURS WITHIN MINS TO HRS. FEVER, CHILLS, NAUSEA, HEADACHE, FLUSHING, TACHYCARDIA, PALPITATIONS.
CONSIDERATIONS: STOP THE TRANSFUSION. SUPPORTIVE CARE: ANTIPYRETICS (AVOID ASPIRIN IN THROMBOCYTOPENIC CLIENTS)

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14
Q

DISCUSS SEPSIS

A

CAUSE: CONTAMINATED BLOOD PRODUCTS.
SYMPTOMS: OCCUR WITHIN MINS TO LESS THAN 24 HRS. TACHYCARDIA, HYPOTENSION, HIGH FEVER, CHILLS, SHOCK.
CONSIDERATIONS: STOP THE TRANSFUSION, OBTAIN BLOOD CULTURE, ANTIBIOTICS IV FLUIDS, VASOPRESSORS, STEROIDS.

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15
Q

DISCUSS CIRCULATORY OVERLOAD

A

CAUSE: LARGE VOL. OVER SHORT TIME.
SYMPTOMS: OCCURS WITHIN MINS TO HRS. DYSPNEA, CRACKLES, INCREASED RESP. RATE, TACHYCARDIA.
CONSIDERATIONS: MONITOR CLIENTS AT HIGH RISK (ELDERLY, CHILDREN, HD), SLOW OR DISCONTINUE TRANSFUSION.

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16
Q

WHAT ARE AUTOLOGOUS TRANSFUSIONS - BENEFITS AND CONTRAINDICATIONS

A

A PRE-OPERATIVE DONATION COLLECTED 4-6 WEEKS BEFORE SURGERY IN WHICH THE CLIENT RECEIVES THEIR OWN BLOOD FOR THEIR TRANSFUSION. IRON SUPPLEMENTS MAY BE ORDERED.
BENEFITS: PREVENTION OF VIRAL INFECTION FROM DONATED BLOOD. USED FOR CLIENTS WITH HX OF TRANSFUSION REACTIONS. RARE BLOOD TYPE.
CONTRAINDICATIONS: ACUTE INFECTION. CHRONIC DISEASE. HEMOGLOBIN LESS THAN 11g/L, HEMATOCRIT LESS THAN 33%. CEREBROVASCULAR DISEASE. CARDIOVASCULAR DISEASE.

NCLEX (3 decks)

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