Blood Products and Administration

Question 1

Universal blood donor

Answer 1

O negative

Question 2

Universal blood recipient

Answer 2

AB positive

Question 3

What is whole blood?

Answer 3

Red cells, white cells, platelets, electrolytes, plasma, antibodies, added anticoagulant

Question 4

Indication for whole blood transfusion

Answer 4

Massive blood loss

Question 5

Unit volume of whole blood

Answer 5

500 mL

Question 6

What are packed red blood cells?

Answer 6

Contains mainly red cells (plasma removed) and some white cells

Question 7

Indications for packed red blood cell transfusion

Answer 7

To raise H & H

Question 8

What does one unit of packed red blood cells do to the hematocrit level?

Answer 8

Raises by 3

Question 9

What does one unit of packed red blood cells do to the hemoglobin level?

Answer 9

Raises by 1

Question 10

Unit volume of packed red blood cells

Answer 10

300 mL

Question 11

What are platelets?

Answer 11

The second reduction process of whole blood: platelets are separated from plasma

Question 12

Unit volume of platelets for transfusion

Answer 12

50-70 mL

Question 13

Indications for platelet transfusion

Answer 13

1. Presence of bleeding (petechiae, gum bleeding, blood in stool/urine, frank bleeding
2. Platelet count

Question 14

What does one unit of platelets increase the platelet count by?

Answer 14

5,000

Question 15

What is fresh frozen plasma?

Answer 15

Plasma separated from whole blood and then frozen

Question 16

Unit volume of fresh frozen plasma

Answer 16

200-250 mL

Question 17

Indications for fresh frozen plasma transfusion?

Answer 17

Known clotting deficiencies, DIC, liver disease, warfarin reversal

Question 18

Does fresh frozen plasma need to be matched to blood type?

Answer 18

Yes

Question 19

Should fresh frozen plasma be filtered during transfusion?

Answer 19

No

Question 20

What is cryoprecipitate?

Answer 20

Prepared from plasma and contains factor VIII, von Willebrand’s factor, factor XIII, and fibrinogen

Question 21

Unit volume of cryoprecipitate

Answer 21

5-20 mL

Question 22

Indications for cryoprecipitate

Answer 22

Hemophilia A (Factor VIII deficiency), von Willebrand’s disease, factor XIII deficiency

Question 23

What is albumin?

Answer 23

Plasma derivative not ABO or Rh matched

Question 24

What are the available concentrations of albumin?

Answer 24

5% and 25%

Question 25

Indications for albumin

Answer 25

Volume expansion when crystalloid solutions are not adequate and/or when there is capillary leak

Question 26

Action of albumin

Answer 26

Provides oncotic pressure to keep plasma fluid in the intravascular space

Question 27

A patient is going to have a blood transfusion. When should the nurse take the patient's vital signs?

Answer 27

30 minutes prior to transfusion, 15 minutes after beginning transfusion, and within 15 minutes of the end of transfusion.

Question 28

What is the preferred gauge size for blood product administration?

Answer 28

18 to prevent cell destruction, however 20 may be used

Question 29

How long can blood tubing be uses?

Answer 29

24 hours or 6 units of blood products

Question 30

Should the nurse use clean or sterile gloves when administering blood products?

Answer 30

Clean gloves

Question 31

Why should you not prime blood administration tubing with lactated ringers or dextrose solution?

Answer 31

They will hemolyze red cells

Question 32

Can medications be added to blood products?

Answer 32

NO

Question 33

Can medications be piggy packed to blood products?

Answer 33

NO

Question 34

Once blood has left the blood bank, how long is it good for?

Answer 34

4 hours

Question 35

How much blood should be transfused in the first 15 minutes?

Answer 35

No more than 30 mL

Question 36

Febrile non-hemolytic reaction: definition

Answer 36

1. Immediate or with 6 hours 2. Most common and often occurs in patients who have had multiple transfusions 3. Antigen-antibody response to the donor's WBC's

Question 37

Febrile non-hemolytic reaction: symptoms

Answer 37

Sudden chills, fever, headache, flushing, anxiety, muscle pains, chest pain, dyspnea, N&V

Question 38

Febrile non-hemolytic reaction: interventions

Answer 38

1. STOP TRANSFUSION | 2. Administer antipyretics

Question 39

Allergic reaction: definition

Answer 39

1. During transfusion or with 1 hour post | 2. Sensitivity to foreign plasma proteins

Question 40

Allergic reaction: symptoms

Answer 40

Flushing, itching, hives (urticaria)

Question 41

Allergic reaction: interventions

Answer 41

1. STOP TRANSFUSION | 2. Administer antihistamines as ordered

Question 42

Acute hemolytic reaction: definition

Answer 42

1. Usually occurs in first 5-15 minutes 2. ABO or Rh incompatibility, happens when blood is mislabeled, patients T&C are mislabeled, patient not properly admitted

Question 43

Acute hemolytic reaction: symptoms

Answer 43

Chills, fever, low back/flank pain, tachycardia, tachypnea, hypotension, renal failure, hemoglobinuria, cardiac arrest, death, apprehension, headache

Question 44

Acute hemolytic reaction: interventions

Answer 44

1. STOP TRANSFUSION 2. Support ABC's 3. Check VS q 4min

Question 45

Anaphylactic reaction: definition

Answer 45

1. Immediate | 2. Infusion of IgA protein to IgA deficient recipient

Question 46

Anaphylactic reaction: symptoms

Answer 46

Anxiety, urticaria, wheezing, respiratory distress, N&V, diarrhea, cramping, shock, cardiac arrest

Question 47

Anaphylactic reaction: interventions

Answer 47

1. STOP TRANSFUSION 2. Stupport ABC's 3. Administer epinephrine as ordered

Question 48

Fluid volume overload: symptoms

Answer 48

``` Hypertension Bounding pulse Distended jugular veins Dyspnea Restlessness Confusion ```