Clotting Flashcards
A serious bleeding and thrombotic disorder that results from abnormally initiated and accelerated clotting.
DIC
An abnormal response of the normal clotting cascade stimulated by a disease process or disorder.
DIC
Can occur as acute, subacute or a chronic condition.
DIC
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.
Fibrin Split Products
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.
True
In assessing the Integumentary system of a DIC patient what bleeding manifestations do we look for?
pallor, petechiae, purpura, oozing blood, venipuncture site bleeding, hematomas, and occult hemorrhage, hemorrhagic necrosis
In assessing the Respiratory system of a DIC patient what bleeding manifestations do we look for?
tachypnea, hemoptysis, and orthopnea
In assessing the Cardiovascular system of a DIC patient what bleeding manifestations do we look for?
tachycardia and hypotension
In assessing the GI system of a DIC patient what bleeding manifestations do we look for?
upper and lower GI bleeding, abdominal distention, and bloody stools
In assessing the Urinary system of a DIC patient what bleeding manifestations do we look for?
hematuria
In assessing the Neurologic system of a DIC patient what bleeding manifestations do we look for?
vision changes, dizziness, headache, changes in mental status, and irritability
In assessing the Musculoskeletal system of a DIC patient what bleeding manifestations do we look for?
bone and joint pain.
In assessing the Integumentary system of a DIC patient what thrombotic manifestations do we look for?
cyanosis, ischemic tissue necrosis (e.g., gangrene)
In assessing the Cardiovascular system of a DIC patient what thrombotic manifestations do we look for?
electrocardiogram (ECG) changes and venous distention
In assessing the Respiratory system of a DIC patient what thrombotic manifestations do we look for?
tachypnea, dyspnea, pulmonary emboli, and acute respiratory distress syndrome (ARDS)
In assessing the GI system of a DIC patient what thrombotic manifestations do we look for?
abdominal pain and paralytic ileus
In assessing the Urinary system of a DIC patient what thrombotic manifestations do we look for?
Kidney damage and oliguria, leading to failure.
Treatment of underlying disease may be sufficient to reverse ________.
DIC
Thrombocytopenia is when platelet numbers drop below ________.
150,000 platelets per microliter
What is the normal platelet range for clotting?
150,000-400,000 platelets per microliter
Thrombocytopenia is usually asymptomatic unless the count drops below _______ at which time abnormal bleeding may occur in response to trauma.
50,000 platelets per microliter
Spontaneous major bleeding episodes do not generally occur unless the platelet count falls below ________.
20,000 platelets per microliter
Platelets are transfused when a patient’s platelet count is less than ________ or if there is active bleeding
10,000 platelets per microliter
In what type of thrombocytopenia are antibodies created by the patient to attack their own platelets?
Immune Thrombocytopenia Purpura (Idiopathic Thrombocytopenia)
Transfused platelets can be just as rapidly destroyed as patient’s own platelets in which type of thrombocytopenia?
Immune Thrombocytopenia Purpura (Idiopathic Thrombocytopenia)
Receiving Heparin over 1 week and numbers of exposure to heparin are risk factors for which type of thrombocytopenia?
Heparin Induced Thrombocytopenia
Untreated Thrombotic Thrombocytopenia Purpura (TTP) is often fatal within ___ months?
3
What are the four required components for each blood products bag?
- the lot number
- unique facility identifier
- product code
- ABO group and Rh type of donor
True or False
Rh positive blood can be given to Rh negative patients.
False
True or False
Rh positive blood or Rh negative blood may be given to Rh positive patients.
True
Do not use dextrose solutions or lactated ringers for administering blood because they will cause RBC _______.
hemolysis
Improper ______ to ________ identification is the most common cause of hemolytic transfusion reactions.
product to patient
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.
diphenhydramine (Benadryl) and acetaminophen
If blood is not used within ____ minutes return it to the blood bank.
30
During the first ___ minutes or 50 mL of blood infusion, remain with the patient.
15
The rate of infusion during the first 15 minutes of a blood transfusion should be no more than ___ mL/minute.
2
Blood transfusions should not take more than 4 hours to administer because of the increased risk of ________ growth.
bacterial
Type ___ blood will form antibodies against Type B blood.
A
Type ___ blood will form antibodies against Type A blood.
B
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.
1
Given to patients who have clotting deficiencies like DIC, Hemorrhage, massive transfusions, liver disease, vitamin K deficiency, and excess Coumadin (warfarin).
Fresh Frozen Plasma
It is a hyperosmolar solution—helps move water from extravascular space to intravascular space
Albumin
A new cross match is required every ___ hours.
72
What gauge needle is preferred for blood infusions?
18 or larger
Assess the patient every ___ minutes during the transfusion
30
___________ occurs when blood is administered too quickly
Circulatory overload
________ may be needed if renal failure develops for an acute hemolytic reaction.
Dialysis
Treatment for a bacterial (sepsis) reaction during a blood transfusion includes
- ______
- ______
- ______
- ______
- obtain blood cultures
- antibiotics
- iv fluids
- vasopressors
