Clotting

Question 1

A serious bleeding and thrombotic disorder that results from abnormally initiated and accelerated clotting.

Answer 1

DIC

Question 2

An abnormal response of the normal clotting cascade stimulated by a disease process or disorder.

Answer 2

DIC

Question 3

Can occur as acute, subacute or a chronic condition.

Answer 3

DIC

Question 4

Excessive clotting activates the fibrinolytic system, which in turn breaks down the newly formed clot, creating ____________. These products also have anticoagulant properties and inhibit normal blood clotting.

Answer 4

Fibrin Split Products

Question 5

True or False
Bleeding in a person with no previous history or obvious cause should be questioned because it may be one of the first manifestations of acute DIC.

Answer 5

True

Question 6

In assessing the Integumentary system of a DIC patient what bleeding manifestations do we look for?

Answer 6

pallor, petechiae, purpura, oozing blood, venipuncture site bleeding, hematomas, and occult hemorrhage, hemorrhagic necrosis

Question 7

In assessing the Respiratory system of a DIC patient what bleeding manifestations do we look for?

Answer 7

tachypnea, hemoptysis, and orthopnea

Question 8

In assessing the Cardiovascular system of a DIC patient what bleeding manifestations do we look for?

Answer 8

tachycardia and hypotension

Question 9

In assessing the GI system of a DIC patient what bleeding manifestations do we look for?

Answer 9

upper and lower GI bleeding, abdominal distention, and bloody stools

Question 10

In assessing the Urinary system of a DIC patient what bleeding manifestations do we look for?

Answer 10

hematuria

Question 11

In assessing the Neurologic system of a DIC patient what bleeding manifestations do we look for?

Answer 11

vision changes, dizziness, headache, changes in mental status, and irritability

Question 12

In assessing the Musculoskeletal system of a DIC patient what bleeding manifestations do we look for?

Answer 12

bone and joint pain.

Question 13

In assessing the Integumentary system of a DIC patient what thrombotic manifestations do we look for?

Answer 13

cyanosis, ischemic tissue necrosis (e.g., gangrene)

Question 14

In assessing the Cardiovascular system of a DIC patient what thrombotic manifestations do we look for?

Answer 14

electrocardiogram (ECG) changes and venous distention

Question 15

In assessing the Respiratory system of a DIC patient what thrombotic manifestations do we look for?

Answer 15

tachypnea, dyspnea, pulmonary emboli, and acute respiratory distress syndrome (ARDS)

Question 16

In assessing the GI system of a DIC patient what thrombotic manifestations do we look for?

Answer 16

abdominal pain and paralytic ileus

Question 17

In assessing the Urinary system of a DIC patient what thrombotic manifestations do we look for?

Answer 17

Kidney damage and oliguria, leading to failure.

Question 18

Treatment of underlying disease may be sufficient to reverse ________.

Answer 18

DIC

Question 19

Thrombocytopenia is when platelet numbers drop below ________.

Answer 19

150,000 platelets per microliter

Question 20

What is the normal platelet range for clotting?

Answer 20

150,000-400,000 platelets per microliter

Question 21

Thrombocytopenia is usually asymptomatic unless the count drops below _______ at which time abnormal bleeding may occur in response to trauma.

Answer 21

50,000 platelets per microliter

Question 22

Spontaneous major bleeding episodes do not generally occur unless the platelet count falls below ________.

Answer 22

20,000 platelets per microliter

Question 23

Platelets are transfused when a patient’s platelet count is less than ________ or if there is active bleeding​

Answer 23

10,000 platelets per microliter

Question 24

In what type of thrombocytopenia are antibodies created by the patient to attack their own platelets?​

Answer 24

Immune Thrombocytopenia Purpura (Idiopathic Thrombocytopenia)

Question 25

Transfused platelets can be just as rapidly destroyed as patient’s own platelets in which type of thrombocytopenia?

Answer 25

Immune Thrombocytopenia Purpura (Idiopathic Thrombocytopenia)

Question 26

Receiving Heparin over 1 week​ and numbers of exposure to heparin​ are risk factors for which type of thrombocytopenia?

Answer 26

Heparin Induced Thrombocytopenia

Question 27

Untreated Thrombotic Thrombocytopenia Purpura (TTP) is often fatal within ___ months?

Answer 27

3

Question 28

What are the four required components for each blood products bag?

Answer 28

1. the lot number
2. unique facility identifier
3. product code
4. ABO group and Rh type of donor​

​

Question 29

True or False

Rh positive blood can be given to Rh negative patients.

Answer 29

False

Question 30

True or False
Rh positive blood or Rh negative blood may be given to Rh positive patients.​

​

Answer 30

True

Question 31

Do not use dextrose solutions or lactated ringers for administering blood because they will cause RBC _______.

Answer 31

hemolysis

Question 32

Improper ______ to ________ identification is the most common cause of hemolytic transfusion reactions.

Answer 32

product to patient

Question 33

The patient may be premedicated with _______ and ________ to decrease the possibility of reacting to platelet transfusions if he or she has a history of reactions.

Answer 33

diphenhydramine (Benadryl) and acetaminophen

Question 34

If blood is not used within ____ minutes return it to the blood bank.

Answer 34

30

Question 35

During the first ___ minutes or 50 mL of blood infusion, remain with the patient.

Answer 35

15

Question 36

The rate of infusion during the first 15 minutes of a blood transfusion should be no more than ___ mL/minute.

Answer 36

2

Question 37

Blood transfusions should not take more than 4 hours to administer because of the increased risk of ________ growth.

Answer 37

bacterial

Question 38

Type ___ blood will form antibodies against Type B blood.

Answer 38

A

Question 39

Type ___ blood will form antibodies against Type A blood.

Answer 39

B

Question 40

One unit of PRBCs can be expected to result in a hemoglobin increase of ___g/dL or Hct increase of 3% in a typical adult.

Answer 40

1

Question 41

Given to patients who have clotting deficiencies like DIC, Hemorrhage, massive transfusions, liver disease, vitamin K deficiency, and excess Coumadin (warfarin).​

Answer 41

Fresh Frozen Plasma

Question 42

It is a hyperosmolar solution—helps move water from extravascular space to intravascular space

Answer 42

Albumin

Question 43

A new cross match is required every ___ hours.​

Answer 43

72

Question 44

What gauge needle is preferred for blood infusions?

Answer 44

18 or larger

Question 45

Assess the patient every ___ minutes during the transfusion

Answer 45

30

Question 46

___________ occurs when blood is administered too quickly​

Answer 46

Circulatory overload

Question 47

________ may be needed if renal failure develops for an acute hemolytic reaction.

Answer 47

Dialysis

Question 48

Treatment for a bacterial (sepsis) reaction during a blood transfusion includes

1. ______
2. ______
3. ______
4. ______

Answer 48

1. obtain blood cultures
2. antibiotics
3. iv fluids
4. vasopressors​