hematologic function and blood transfusion (exam 1) Flashcards
where is blood formed?
bone marrow
what are red blood cells important for?
oxygen
what do white blood cells tell us?
infection
what are platelets for?
clotting
what is normal hemoglobin in females?
12-15
what is normal hemoglobin in males?
13-18
what does low hemoglobin mean?
hypoxia or tiredness
what kind of infection has low white blood cells?
viral
what kind of infection ahs high white blood cells?
bacterial
what is the normal platelet level?
150,000-450,000
what happens when platelets are too low?
bleeding
what happens when platelets are too high?
clotting
what is a normal INR?
2-3
what kind of blood has everything in it
whole blood
whole blood given often?
no
what is given in instances of thrombocytopenia and low INRs
platelets
what are packed red blood cells
just red blood cells, everything else removed
what kind of blood is given to chemo patients and immunosuppressed?
WBCs
what kind of blood helps high INR and reverses it
plasma
what is albumin?
protein in plasma
what makes up whole blood?
RBCs, WBCs, plasma, platelets
what is the volume of each unit of whole blood?
around 500 ml
whole blood requires ______ and _______
T&C and ABO identification
is giving whole blood preffered?
no
what controls or prevents bleeding associated with platelet deficiencies?
giving platelets
what treats thrombocytopenia?
platelets
what part of the blood is most commonly transfused?
platelets
does plasma have to be ABO compatible?
yes
what emergently reverses warfarin or coumadin?
fresh frozen plasma
what is the liquid portion of blood and lymph
fresh frozen palsma
what is fresh frozen plasma used for?
-coagulation factor replacement!!!!
-provides clotting factors
-reversal of warfarin!!!
what is given to cancer/chemo patients?
WBCs
_______ are administered for low or abnormal WBC counts
granulocytes
what is used to restore intravascular volume
albumin
what maintains cardiac output in patients with hypoproteinemia?
albumin
what has to do with circulation (CHF), and the push/pull of oncotic pressure?
albumin
what do packed red blood cells do?
-improve oxygen carrying capacity
-provides the same oxygen carrying capacity as whole blood without additional volume
what is the volume of packed RBCs?
250-350 ml
1 unit of packed RBCs raises hgb by ___ g and hct by ____%
1g and 3-4%
infuse packed RBCs over ___ hours maximum
4 hours
what is normal hemoglobin level
12-17
verify blood with the patient and ___ RNs
2
only use ____ with blood products
0.9% saline (normal slaine)
stay in the room for ____ mins during administration
15
what should you tach a patient about their blood administration?
what kind, risks, why, follow-up
what kind of tubing do you use for blood?
y-tubing
when priming y tubing with saline and blood, which fluid goes all the way down to prime?
saline all the way down, and then blood to the chamber
what are symptoms of an allergic reaction to blood
hives, itching, anaphylaxis
what are symptoms of a febrile blood reaction
fever, chills, headache
symptoms of a hemolytic reaction
immediate onset, flushing, fever, chills, back pain, shock
what to do about a transfusion reaction?
stop infusion and start normal saline
what is too much fluid characterized by SOB, HTN, and hypoxia
transfusion associated circulatory overload (TACO)
what to do about a TACO
continue to monitor pt., notify MD, keep going
you are prepping to hang 1U PRBCs, what type of fluid should you get?
-lactated ringers
-hypotonic
-hypertonic
-normal slaline
normal saline
decrease in RBC count
anemia
what is the lifespan of RBCs
120 days
what transports oxygen to cells
RBCs
___ and ___ remove old RBCs
spleen and liver
some hemoglobin breaks down to form ______
bilirubin
95% of RBCs is ______
hemoglobin
bone marrow needs what makes new RBCs?
iron, B12, folate, B6, and protein
what is the most common symptom of anemia?
fatigue
what are signs of anemia?
fatigue/weakness
pallor
jaundice
tongue red and smooth
red sore tongue
what kind of anemia has jaundice
megaloblastic and hemolytic
what kind of anemia has a red smooth tongue?
iron deficiency
at kid of anemia has a red sore tongue?
megaloblastic
what are immature RBCs in blood?
reticulocytes
what is the average size of a RBC called
mean corpuscle volume
what is needed for hematopoiesis
serum B12 and folate
what evaluates iron metabolism and storage
iron studies
what do iron studies show?
serum iron, total iron binding capacity, transferrin saturation, ferritin
what kind of anemia is where there is not enough blood being made?
hypo-proliferative
what kind of anemia involves dying cells?
hemolytic
what kind of anemia is where iron intake is inadequate for hbg synthesis
iron deficiency anemia
what is the most common type of anemia?
iron deficiency anemia
what are symptoms of iron deficiency anemia?
smooth red tongue
brittle ridged nails
cracks in mouth
how to diagnose iron deficiency anemia?
bone marrow aspiration, labs (ferritin, H&H, low iron, elevated transferrin)
whats the treatment for iron deficiency anemia?
high iron diet and iron supplements
how should you take iron supplements?
on empty stomach, with vitamin C, no dairy (like milk)
what kind of anemia is caused by chronic inflammation, chronic infection, and malignancy?
anemia of chronic disease (normocytic)
what is anemia of chronic disease also called?
normocytic
what are symptoms of anemia of chronic disease?
few (Chronic) HGB rarely greater than 9
what is the treatment of anemia of chronic disease?
treat underlying chronic disease, supplements dont help
what are the types of hypo-proliferative anemia?
-iron deficiency anemia
-anemia of chronic disease
-aplastic anemia
-megaloblastic anemia (pernicious)
what type of rare anemia causes damage to stem cells and bone marrow, causing decreased RBCs
aplastic anemia
what type of anemia is an auto-immune reaction to a med
aplastic anemia
what is the treatment for aplastic anemia
stem cell transplant and immunosuppression
what kind of anemia is abnormally large RBCs due to lack of B12 or folate?
megaloblastic anemia
another word for megaloblastic anemia?
pernicious anemia
what are symptoms of megaloblastic anemia?
pancytopenia (all blood comps. low)
abnormally shaped cells
what are risk factors of megaloblastic anemia?
pregnancy ETOH use, pernicious anemia
low B12 may cause….
confusion, weakness, N/T, balance issues
what is the treatment of megaloblastic anemia?
folate or B12 replacement, diet change
what is caused by sudden loss of a large volume of blood?
blood loss anemia
what can blood loss anemia be caused from?
trauma, surgery, bleeding disorders
what is treatment of blood loss anemia?
treat underlying blood loss (tourniquet)
transfuse PRBCs
what is when RBCs have a shortened lifespan?
hemolytic anmeia
what are symptoms of hemolytic anemia?
decreased O2, hypoxia, jaundice
what is a severe type of hemolytic anemia from an inherited sickle cell hemoglobin gene that causes abnormal shape of cell
sickle cell anemia
what is the RBC lifespan with sickle cell
4-10 days
what are some symptoms of sickle cell
jaundice, tachy, murmurs, cardiomegaly, HF, pain, hypoxic damage
what is the life expectancy of sickle cell
50s
what are complications of sickle cell
clots, CVA, sickle cell crisis
what is the treatment of sickle cell?
stem cell transfusions, hydroxyurea (chemo drug), blood transfusions
what is the management of sickle cell?
hydration, oxygen, pain meds
what are complications from anemia in general?
HF, CP, paresthesia/confusion, falls, activity intolerance
pt. complains of fatigue and a red smooth tongue, what lab value is important to check?
-WBC
-B12
-iron
-platelets
iron (symptoms of iron-deficiency anemia)
