Blood Transfusions PowerPoint Flashcards
1
Q
Blood Transfusion =
A
Infusion of whole blood or blood components into venous circulation
2
Q
Proteins on the surface of red blood cells, they’re unique to each person =
A
Antigens
3
Q
Promotes Agglutination (The clumping of cells) =
A
Antigens
4
Q
What antigens are the most important in determining blood group or type?
A
A, B, and Rh
5
Q
Are there any A or B antigens present in the O blood type?
A
No
6
Q
During a blood transfusion, the blood group of the donor and recipient must match to avoid -
A
An antigen-body reaction and the destruction (Hemolysis) of red blood cells
7
Q
The universal RBC donor is-
A
0 -
8
Q
The universal RBC recipient is-
A
AB +
9
Q
A types can be donated to -
A
A, AB
10
Q
B types can be donated to -
A
B, AB
11
Q
AB types can be donated to -
A
Other AB types
12
Q
O types can be donated to -
A
Any of the other blood types
13
Q
What % of Americans have Rh?
A
85%
14
Q
If a an Rh- mother is carrying an Rh+ fetus or if transfusing a Rh+ blood type to a Rh- patient, what does this place them at risk of?
A
Antigen-antibody reaction and hemolysis of RBC’s
15
Q
What do you need to assess pregnant women for when it comes to blood?
A
If the pregnant woman’s blood is compatible with the neonate’s
16
Q
The study of blood =
A
Hematology
17
Q
How can a nurse determine the possible interactions of antigens with antibodies?
A
Crossmatching
18
Q
RBC’s from the donor and serum from the recipient are mixed. A reagent is added and then is examined for
clumping of cells.
This is called-
A
Crossmatching
19
Q
RBC’s from the donor and serum from the recipient are mixed during a crossmatching. What is the reagent called that you are about to add to this to assess for the clumping of cells?
A
Coomb’s Serum
20
Q
If clumping (agglutination) occurs during a crossmatching, the risk of a transfusion reaction is-
If it does not occur then it is-
A
High
Low
21
Q
List the types of products for blood transfusions:
A
Whole blood
Packed Red Blood Cells (PRBC’s)
Autologous red blood cells
Platelets
Fresh frozen plasma
Albumin and plasma protein fraction
Clotting factors and cryoprecipitate
22
Q
Blood in the state as it flows within our bodies, with none of its components removed =
A
Whole Blood
23
Q
What does whole blood replace?
A
Blood Volume + All Blood Products
24
Q
Is Whole Blood commonly used?
A
Nah
25
When a might whole blood be used?
May be used in extreme, acute hemorrhage
26
Used to increase the oxygen carrying capacity of blood in anemias. Used to replace Erythrocytes (RBC’s) =
Packed Red Blood Cells
27
One unit of Packed Red Blood Cells raises Hemoglobin level by-
It raises Hematocrit by-
Hemoglobin = 1 g/dL
Hematocrit = 3 %
28
A change in lab values will take how long after a packed red blood cells transfusion to complete?
4 - 6 hrs
29
Infusion time for 1 unit of Packed Red Blood Cells =
4 hrs
30
Client donates his/her own blood within 5 weeks of need but ends at least 3 days prior to date of potential transfusion =
Autologous Transfusion
31
Autologous Transfusion is not an option for patient’s with-
Leukemia or Bacteremia
32
Autologous Transfusions can be carried out every how many days if their hgb values are safe?
Every 3 days
33
These kinds of transfusions are typically used if you have an upcoming surgical procedure =
Autologous Transfusion
34
Used to treat thrombocytopenia and platelet dysfunctions =
Platelets
35
Are fresh platelets more effective than older platelets?
Yup
36
Is crossmatching required for platelets?
No, but they’re still typically done anyway
37
Platelets are to be administered -
Rapidly (over 15-30 mins)
38
Each unit of platelets will increase platelet count by approximately -
5,000 - 10,000
39
Expands blood volume + Provides clotting factors + Contains no platelets =
Fresh Frozen Plasma
40
Fresh Frozen Plasma is infused within how many hours of thawing?
How long does it take to infuse?
2 hrs
15 - 30 mins
41
What is required to receive Fresh Frozen Plasma?
Rh compatibility & ABO compatibility
42
Blood volume expander + Provides plasma proteins + Prepared from plasma =
Albumin & Plasma Protein Fraction
43
Used to replace clotting factors: factor VIII & fibrinogen.
Also provides different factors involved in clotting pathway =
Cryoprecipitates
44
Cryoprecipitates are prepared from -
Fresh Frozen Plasma
45
Cryoprecipitates can be stored for how long?
1 Year
46
Once Cryoprecipitates are thawed do they have to immediately be used?
Yup
47
Cryoprecipitates should be administered for -
Over 15 - 30 mins
48
What are the types of blood donations?
Autologous
Blood Salvage
Designated Donor
49
Harvesting the red cells shed during surgery, then transfusing it back into the pt’s body after the surgery ends =
Blood Salvage
50
What 3 bodily systems are especially important to assess before a blood transfusion?
Renal, Circulatory, & Respiratory Status
51
What do you do if a pt’s temp is elevated before a transfusion?
Notify the provider before the transfusion
52
What must always be used when administering blood transfusions?
0.9% Normal Saline
53
What gauge needle do you need for a blood transfusion?
14 Gauge - 22 Gauge
54
Would you need a smaller or larger gauge if you want to administer blood rapidly?
Larger sizes may be preferred
55
You can’t store RBC’s in the-
Refrigerator on the nursing unit
56
Transfusion must be complete within how many hours of initiation?
4 hrs
57
Do you need a new blood administration set with every one unit of blood or different component?
Yes
58
If there is a discrepancy with the pt’s prescription, consent form, client ID, unit ID, blood type, expiration date, compatibility, or appearance, what do you do?
How many people are required to check all of these things?
Don’t perform the infusion, notify the blood bank.
2 Licensed Nurses
(Can be 2 RN’s OR it could be 1 RN & 1 LPN)
59
Should you pre-medicate the pt if prescribed?
Ye
60
PO meds (Like Acetaminophen or Diphenhydramine) should be given how many minutes prior to transfusion?
30 mins
61
How long must the nurse observe the pt during the blood transfusion?
During the first 15 mins OR when the first 50 mL of blood is administered
62
Blood should be run slowly at first, at-
1-2 mL/min
63
The transfusion record should include:
Client information
2. Unit information
Blood/transfusion information
2 signatures
If an IV pump/blood warmer is used
Vital signs
Date/times of transfusion
Volume infused
64
You should document the time the infusion was completed + how much was infused.
True or false?
True
65
What are all the things that you’d document for a blood transfusion?
Record start & completion times of the transfusion
Name 2 individuals who started & ended
Transfusion type & verified client
Product and volume infused
The blood unit number
Sequence number (1 of 3 prescribed units)
Vital signs
Also record as intake on the I/O record
Immediate response to therapy
66
What are the types of transfusion reactions?
Hemolytic Transfusion Reaction
Febrile
Allergic
Transfusion-Associated Graft-Versus-Host Disease (GVHD)
Septicemia (Bacterial Reaction)
67
What are the signs of an immediate reaction to a blood infusion?
Chills & Diaphoresis (Sweating)
Muscle Aches, Back Pain, or Chest Pain
Rash, Hives, Itching, & Edema
Rapid, Thready Pulse
Dyspnea, Cough, or Wheezing
Pallor and Cyanosis
Apprehension
Tingling and Numbness
Headache
N/V, Abdominal Cramping, and Diarrhea
68
What are the signs of an immediate reaction to a blood infusion in an unconscious pt?
Weak Pulse
Fever
Tachycardia or Bradycardia
Hypotension
Visible Hemoglobinuria
Oliguria or Anuria
69
What are the clinical signs of a Hemolytic Transfusion Reaction?
Fever or Chills
Flank Pain
Reddish or Brown Urine
Tachycardia
Hypotension
70
What are the clinical signs of a Febrile Reaction to a blood transfusion?
Fever
Chills
Warm, Flushed Skin
Headache
Anxiety
Nausea
71
What are the clinical signs of an Allergic Reaction to a blood transfusion?
Dyspnea
Stridor
Decreased O2 Saturation
Chest pain
Flushing
72
What are the priority nursing actions if client experiencing a reaction?
1.) Stop transfusion
2.) Change IV tubing and infuse NS
3.) Notify HCP and blood bank
4.) Stay with client. Monitor s/s and vital signs as often as every 5 minutes
5.) Administer emergency meds as prescribed
6.) Obtain blood/urine specimens as prescribed
7.) Return blood bag, tubing, attached labels, and transfusion record to blood bank.
8.) Document occurrence, action taken, and client’s response
73
Who’s responsible for identifying the type of reaction it is that the patient is having from a blood infusion?
The blood bank and laboratory
74
What are the possible complications from a blood infusion?
Transfusion Reactions
Circulatory Overload
Septicemia
Iron Overload
Disease Transmission
Hypocalcemia
Hyperkalemia
Citrate Toxicity
75
Blood poisoning by bacteria =
Septicemia
76
Septicemia Symptoms =
Chills.
Confusion / Delirium
Fever OR Hypothermia
Lightheadedness due to Hypotension
Tachycardia
Skin Rash or Mottled Skin
Warm Skin
77
Circulatory Overload Symptoms =
Dyspnea (Worsens as Pulmonary Edema increases)
Orthopnea
Chest Tightness
Cough
Tachycardia
Hypertension
Acute Respiratory Distress (Crackles)
78
Iron Overload Symptoms =
Fatigue
Weight Loss
Joint Pain
Brain Fog
Mood Swings
Depression & Anxiety
Erectile Dysfunction
Impacted Menstrual Cycle
79
What’s the most commonly transmitted disease via blood transfusion?
Hepatitis C
80
Aside from Hep C, what are other commonly transmitted diseases that can be given via blood transfusion?
Hepatitis B, HIV
81
Citrate in transfused blood binds to calcium and then is excreted. This causes-
Hypocalcemia
82
When should you monitor a pt’s Serum Calcium level?
Prior to and after transfusion
83
How can you deal with hypocalcemia during blood transfusions?
You should monitor for it, keep an eye out for any signs of hypocalcemia, transfuse the blood slowly
84
What do you do if the pt starts showing hypocalcemia symptoms during the infusion?
Notify the provider
85
How can a blood transfusion cause Hyperkalemia?
Blood that is stored frees K+ through hemolysis
86
The older the blood, the greater the risk for-
Hemolysis (& Hyperkalemia by proxy)
87
Why should renal pt’s receive fresh blood?
To avoid hyperkalemia
88
When should you monitor a pt’s Potassium level?
Prior to and after infusion
89
How should you deal with the risk of Hyperkalemia when doing a blood transfusion?
You should monitor for it, keep an eye out for any signs of hypocalcemia, transfuse the blood slowly
90
Rapid infusion of multiple units of stored blood may cause-
Hypocalcemia & Hypomagnesemia
91
How does rapid infusion of multiple units of stored blood cause Hypocalcemia & Hypomagnesemia?
Citrate binds calcium and magnesium
92
What occurs whenever Hypocalcemia & Hypomagnesemia occur at the same time?
Citrate Toxicity
93
Citrate Toxicity results in-
Myocardial Depression + Coagulopathy
94
Pt’s with liver dysfunction or infants with immature liver function are at risk for-
Citrate Toxicity
95
How does one treat Citrate Toxicity?
Slow/stop infusion; replacement therapy
96
Religion against donating blood =
Jehovah’s Witness
