blood ppts Flashcards
what is the timeframe that blood components need to be used
what about blood products
Components need to be with 4 hours from blood bank (fridge) and products within 4 hours of spiking the bag.
What is the difference between a blood component and a blood product
Therapeutic component of blood intended for a transfusion and any therapeutic product derived from human blood or plasma and is produced by a manufacturing process
There are many checks that must occur with blood transfusions. What are the 2 most critical checks for blood compatibility
Blood type and Rh factor
What must be checked prior to administering any blood or blood product
Name of patient, DOB, MRN, blood type, Rh factor, expiry date and time, crossmatch results, product number
Which type of IV set can be used when giving a blood transfusion
Only straight filtered sets are used with no “Y’s
A new IV line must be used for each unit of blood to be transfused
t or f
true!
newest policy as filter works best with the first unit of blood
How often should VS be taken when giving a blood transfusion
rate that the line should run at to start
peds rate
Baseline, 5 mins, 15 mins and then q 1 h
Blood transfusions start slow at 50 ml/hr for adults. Peds 1ml/kg/hr.
A blood transfusion should be infused within a certain time frame once delivered from the blood bank
Within 4 hours once out of the blood bank fridge.
A transfusion reaction is most likely to occur during which time frame
Within 5-15 minutes
Your patient is complaining of chills and a fever. You suspect a transfusion reaction. What will be your actions
Stop the transfusion, start normal saline, VS’s and call the doctor.
. Be sure to mention disconnecting blood right at IV site so no more goes in – problem with nexiva catheters though! It mentions that with severe reactions with less than 10 mls of blood can occur! (“only a few mls”)
Your patient is having a severe transfusion reaction. What does this look like
Respiratory distress, fever, chills, nausea, chest tightness, back pain, anxiety
Fever, chills and muscle stiffness what is likely happening
febrile nonhemolytic reaction – begins about 2 hours after transfusion is started, non-life threatening but uncomfortable
pt is having Dyspnea, tachycardia, anxiety, orthopnea and cough
what is likelyt he problem
what can be done to prevent this
– circulatory overload – also can have JVD, increased BP and frothy pink sputum.
Need Lasix between units and units given slowly. If severe, d/c transfusion give O2 and call doctor, saline lock IV
cn you store blood products in the fridge until use
no! they must be kept at specific temp
what soln must IVIG be run with
d5W
What are the steps you would take after a transfusion reaction occurs and patient has been stabilized
You would recheck all the labelling, ID on patient etc., inform the blood bank, notify physician (should have already anyway!), keep the blood component/product to send to the blood bank for analysis, blood cultures if it’s a suspected infection and fill out all documentation forms per policy of the institution
what are blood components
what are blood products
PRBC’s
Plasma
Platelets
Cryoprecipitate (made from plasma)
Blood Products
Albumin
IVIG
Rhogam
who are cytomegalovirus negative given to & what is it
Indications- CMV negative blood is often given to premature infants, those infants under 4 weeks of age, and clients undergoing intrauterine transfusions. Other clients – bone marrow or organ transplant recipients, HIV or AIDS, spleenectomy, immunocompromised clients, pregnant women.
what type of blood therapy has highest risk of leading to septicemia
platelets as they are stored at rom temp
there are also fresh frozen platelets
pts who have ITP immune thrombocytopenia purpura should they get platelets
what blood product hsould they receive
who else might need this
patients with idiopathic thrombocytopenia purpura (ITP) should not receive platelet transfusions unless bleeding is significant or life threatening. Platelet transfusion given to clients with ITP will be rapidly removed from circulation by the client’s anti-platelet antibodies and thus will be, at most, only of transient benefit
IVIG - human immunoglobulins replacement for treatment of some auto immune diseases (chronic fatigue syndrome), treatment for Kawasaki’s in pediatrics, Guillian-Barre, idiopathic thrombocytopenia purpura.
do you need to keep ABO or Rh compatability in mind when giving plasma
must be ABO compatible. Rh factor need not be considered
what is fresh frozen plasma and how long can it be kept
indications for use FFP
Fresh Frozen Plasma is unconcentrated form of blood plasma containing all of the clotting factors except platelets.
Stored at minus 18 degrees Celsius or lower for up to one year.
FFP is indicated for: massive transfusion (replacement of the patient’s blood volume in < 24 hours) with deficiency of Factor VIII and V, otherwise frozen plasma is adequate. -exchange transfusion in neonates.
when not to use fresh frozen plasma
- dont use when coagulopathy can be corrected with more specific therapy eg cryoprecipitate or a factor
- dont use when can inc blood vol w NS or other solns
what is cryoprecipitate and when is it indicated
Cryoprecipitate – is a low purity concentrate of 3 hemostatic proteins prepared from donated whole blood. A single bag of Cryo contains an average of 100units of factor VIII and von Willebrand factor, and 150-200mg of fibrinogen with some factor XIII and fibronectin. Made from plasma, fibrinogen and factors 8 and 13
for patients bleeding with low fibrinogen levels.
what is the only fibrinogen conc available for IV use
Cyro is the only fibrinogen concentrate available for IV use.
what pt would need factor VIII
factor IX
VIII is from human plasma to treat clients with Hemophilia A or von Willebrand’s disease.
IX – is from human plasma to treat clients with Hemophilia B (factor IX deficiency). It may be of value to clients with congenital factors X or II (prothrombin) deficiency.
