Blood Transfusion

Question 1

what is autologous

Answer 1

own blood

Question 2

what is homologous

Answer 2

standard donation

Question 3

what is Rh factor positive

Answer 3

d antigen present

Question 4

what is rh negative

Answer 4

no d antigen

Question 5

what can expose you to d antigens

Answer 5

fetomaternal
blood transfusion of rh+ blood

Question 6

what is RhoGAM

Answer 6

given to prevent hemolytic anemia

Question 7

people who are Rh- can get Rh positive blood t/f

Answer 7

f

Question 8

what is crossmatching

Answer 8

Recipient serum tested against donor cells
 Determines if recipient has any pre-formed
antibodies against antigens in the donor’s cells
 See agglutination & clumping if incompatible

Question 9

how long is crossmatching good for

Answer 9

3 days bc new antibodies might form

Question 10

what can be transfused

Answer 10

whole blood
Packed RBCs
Platelets
Fresh Frozen Plasma
Cryoprecipitate
White Blood Cells (Granulocytes)
Albumin (not treated as a blood product)

Question 11

how many ml of whole blood

Answer 11

500

Question 12

how many ml pf packed rbcs

Answer 12

250

Question 13

packed rbcs given when hgb is

Answer 13

<6-7

Question 14

range of when platelets given

Answer 14

10,000-20,000

Question 15

what can cause sepsis if given at room temp

Answer 15

platelets

Question 16

how long are platelets transfused for

Answer 16

15-30 min

Question 17

what do you give for platelet rigors

Answer 17

benadryl and tylenol

Question 18

what does freezing plasma do

Answer 18

preserve clotting factors

Question 19

how much of frozen plasma is given

Answer 19

200-250 ml

Question 20

what rate does fresh frozen plasmatransfuse at

Answer 20

10 mL/min

Question 21

cryoprecipitate is a rich source of

Answer 21

fibrinogen

Question 22

where is cryoprecipitate derived from

Answer 22

plasma

Question 23

what factors are in cryoprecipitate

Answer 23

willlebrand factor, factor 8 and 13

Question 24

when is cryoprecipitate given

Answer 24

fibrinogen <0.8-1 g/L
DIC

Question 25

how fast is cryoprecipitate given

Answer 25

bolus 3-5 min

Question 26

what has a potential for severe reaction

Answer 26

wbcs

Question 27

how fast are wbcs given

Answer 27

45 min-2 hrs

Question 28

albumin is a plasma ….

Answer 28

expander

Question 29

when is albumin given

Answer 29

low volume
liver failure
burns

Question 30

what rate is albumin given at

Answer 30

1-4 ml/min

Question 31

what are you monitoring for with albumin

Answer 31

heart failure

Question 32

what to assess before blood products given

Answer 32

previous reactions
cardiac and resp, urine output, skin
vs assessment after getting blood
iv access- 18-20 gauge

Question 33

what do we premedicate with

Answer 33

benadryl and tlyenol

Question 34

how many nurses to give blood

Answer 34

2

Question 35

devoted IV line primed with…

Answer 35

NS only

Question 36

how long do we stay wiht our pt

Answer 36

1st 15 min and vs @ 15 min

Question 37

vs should be done how often after blood is given

Answer 37

q1 hr

Question 38

transfusion reactions

Answer 38

acute hemolytic reaction
febrile reaction
allergic reaction
Fluid/Circulatory overload
Bacterial contamination  Sepsis/Septic
shock
TRALI
TA-GVHD
Acute pain transfusion reaction (APTR)

Question 39

how much does hbg increased after given

Answer 39

1 gram/unit given

Question 40

what is acute hemolytic reaction

Answer 40

Immediate onset typically
Life threatening
Donor and recipient incompatibility- Rh

Question 41

s/s of acute hemolytic reaction

Answer 41

Apprehension, HA, tachycardia, tachypnea,
hypotension
low back pain/CP, hemoglobinuria, chills, fever
Can lead to acute kidney injury, DIC & shock
Delayed= jaundice (milder form)
IMPENDING DOOM

Question 42

treatment of acute hemolytic reaction

Answer 42

stop transfusion
new iv tubing and NS

Question 43

febrile reaction

Answer 43

most common
onset within firsdt 2 hrs

Question 44

s/s of febrile reaction

Answer 44

fever
chills
tachycardia
hypotension
fluhing
HA
anxiety

Question 45

what can minimize febrile reaction

Answer 45

leukocyte filter

Question 46

onset of mild allergic reaction to blood

Answer 46

during - 24 hrs

Question 47

mild allergic reaction s/s

Answer 47

itching
flusing
hives

Question 48

anaphylactic reaction to blood s/s

Answer 48

immediate onset
wheezing
dyspnea
chest tightness
cyanosis
decreased bp- anaphylactic shock

Question 49

how to treat anyphylatic shock

Answer 49

o2/maintain airway
epinephrine
ns IV fluids- vasopressin if needed
steroids and antihistamines

Question 50

circulatory fluid overload

Answer 50

Cough, SOB, crackles, JVD, hypertension
Slow the transfusion rate
Elevate HOB if symptomatic
Notify MD to order diuretic

Question 51

sepsis

Answer 51

uncommon
Rapid onset chills, fever, dyspnea,
hypotension
Stop transfusion
Notify MD to order blood cultures and antibiotics

Question 52

what is transfusion related acute lung injury

Answer 52

Non- cardiogenic pulmonary edema (ARDS)
Donor cells damage pulmonary
endothelium
Sudden onset within 6 hours of
transfusion
Hypoxia
Pulmonary infiltrates on X-Ray

Question 53

Transfusion-associated graft-vs-host
disease (TA-GVHD)

Answer 53

Rare, high mortality rate
Immunosuppressed patients

Question 54

Acute pain transfusion reaction (APTR)

Answer 54

Uncommon, recently identified
Patho unclear
Does not appear to be life-threatening

Question 55

if reaction occurs…return blood bag and tubing to… and document on

Answer 55

blood bank
transfusion reaction form

Question 56

old blood can cause k+ to

Answer 56

increase

Question 57

calcium levels can … if many units of blood are administered

Answer 57

decrease

Question 58

compensate for loses with

Answer 58

Procrit (EPO)- erythropoeitin
IV iron sucrose (venofer)
Oral iron