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hematologic function and blood transfusion Flashcards

1
Q

what makes blood stuff

A

bone marrow

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2
Q

name some blood componets

A
  • whole blood (everything)
  • platelets
  • RBCs
  • WBCs
  • plasma
  • albumin

plasma and albumin are liquidy parts

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3
Q

should you double check blood type and cross match (ABO compatibility)

A

yeppers

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4
Q

describe whole blood

A
  • RBCs, plasma, WBCs, platelets
  • volume of each unit is ~ 500ml
  • whole blood requires T&C, ABO identification
  • not preferred treatment bc of the amount of volume
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5
Q

describe platelets

A
  • used to control or prevent bleeding associated with platelet deficiencies
  • to treat thrombocytopenia
  • transfused more commonly than any other blood component
  • need to be ABO compatible
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6
Q

describe fresh frozen plasma (FFP)

A

liquid portion of blood and lymph used for:
- coagulation factor replacement (primary use)
- provides clotting factors
- reversal of warfarin (emergent)

needs to be ABO compatible

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7
Q

describe WBCs

A
  • granulocytes administered for low or abnormal WBC count
  • given cancer/chemotherapy patients
  • mus be compatible
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8
Q

describe albumin

A
  • used to resotre intravascular volume
  • -maintains carduac output in patients with hypoproteinemia
  • doesnt have to be compatible
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9
Q

describe packed red blood cells (PRBCs)

A
  • improves oxygen carrying capacity
  • provides the same oxygen carrying capacity as whole blood without the additional volume
  • need to be ABO compatible
  • volume 250-350ml
  • 1 unit raises Hgb 1g and Hct 3-4%
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10
Q

describe admin of PRBCs

A
  • infuse over 4hrs max
  • standard blood admin set with blood filter
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11
Q

what are some nursing considerations for blood products

A
  • physicians orders
  • patient signed informed consent
  • type and cross
  • verification of type anc cross per licensed professionals
  • obatin blood and verify in lab
  • verify blood with pt and two licensed nurses
  • only use 0.9% saline with blood products
  • follow facility’s protocol for admin
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12
Q

infusion nurses society standard for blood admin: describe nurses responsibilities

A
  • verify order
  • blood product inspection
  • pt identification
  • expiration date
  • confirmation of compatibiltiy: pt-donor
  • confirmation of informed pt consent
  • pt education
  • monitoring during and after admin
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13
Q

what tubing is used for blood admin

A

Y

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14
Q

name some different transfusion reactions

A
  • allergic
  • febrile
  • hemolytic
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15
Q

describe an allergic transfusion reaction

A

hives, itching, anaphylaxis

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16
Q

describe febrile transfusion reactions

A

fever, chills, HA

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17
Q

describe hemolytic transfusion reactions

A

immediate onset, flushing, fever, chills, back pain, shock

usually occurs if T&C was incorrect

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18
Q

what do you do if a transfusion reaction occurs

A
  • stop transfusion, start normal saline
  • notify MD
  • follow agency protocols
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19
Q

you are preparing to hang 1 unit of PRBCs. what type of fluid should you gather?

A

normal saline

0.9% sodium chloride or normal saline are the only IV fluids that can be run with blood products

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20
Q

what is anemia

A

decrease in RBC count

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21
Q

whats the lifespan of RBCs

A

120 days

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22
Q

what do RBCs do

A

transport oxygen to cells

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23
Q

what organs remove RBCs

A

spleen and liver remove old RBCs
- most Hgb and iron is recycled
- some Hgb breaks down ro form bilirubin

24
Q

95% of RBCs is…

25
what does bone marrow need to make new RBCs
iron, B12, folate, B6 and protein
26
describe the signs and symtoms of anemia
symptoms may vary based on duration of anemia (acute vs chronic) **most common symptom = fatigue** - malaise/weakness - pallor - jaundice (megaloblastic/hemolytic anemia) - tongue smooth and red (iron deficiency anemia) - red sore tongue (megaloblastic anemia)
27
# diagnostics erythrocytes
4.5 - 5.3 (men) 4.1 - 5.1 (women)
28
# diagnostics hemoglobin
13 - 18 (men) 12 - 16 (women)
29
# diagnostics hematocrit
40% - 50% (men) 38% - 48% (women)
30
# diagnostics what is reticulocyte count
% immature RBCs in blood
31
# diagnostics what is mean corpuscle volume
average size of a RBC
32
serum b12 and folate are needed for...
hematopoiesis
33
describe iron studies
evaluate iron metabolism and storage
34
what are the different classifications of anemia
-hypoproliferative (not making enough or unhealthy shit) -blood loss -hemolytic (cells are destroyed)
35
name different types of hypoproliferative anemia
-iron deficiency anemia -anemia of chronic disease (normocytic) -aplastic anemia -megaloblastic anemia
36
# hypo-proliferative anemia iron deficiency anemia
-iron intake inadequate for Hgb synthesis -most common -**symptoms: smooth red tongue, brittle rdiged nails, cracks in mouth** -Dx: bone marrow aspiration, labs: ferritin, H&H, low iron, elevated transferrin -**treatment: high iron diet, iron supplements**
37
describe taking iron supplements
-take on an empty stomach with vitamin C (OJ) -do not take with dairy -stools may be dark and stain -liq can stain teeth
38
# hypo-proliferative anemia describe anemia of chronic disease (normocytic)
-caused by: chronic inflammation, chronic infection, malignancy -**symptoms: few (chronic) Hgb rarely >9** -**treatment: treat underlying disease, supplements not beneficial**
39
# hypo-proliferative anemia describe aplastic anemia
-rare -causes damage to stem cells and bone marrow, causing decreased RBC production -**treatment: stem cell transplant, immunosupression**
40
# hypo-proliferative anemia describe megaloblastic anemia
abnormally large RBCs due to **lack of B12 or folate**
41
what are the symptoms of megaloblastic anemia
- pancytopenia, abnormally shaped cells - low B12 may cause confusion, weakness, N/V, balance issues
42
what are some risk factors of megaloblastic anemia
pregnancy, ETOH abuse, pernicious anemia
43
what is the treatment for megaloblastic anemia
folate or B12 replacement, diet changes
44
what is blood loss anemia caused by
caused by sudden loss of large volume of blood (trauma, surgery, bleeding disorders)
45
what is the treatment of blood loss anemia
-treat underlying condition -transfuse PRBCs
46
what is hemolytic anemia
-red blood cells have a shortened lifespan
47
what are soe symptoms of hemolytic anemia
decreased O2 -> hypoxia -> stimulates erythropoietin -> release premature RBCs (reticulocytes) -> increased bilirubin -> jaundice
48
name a type of hemolytic anemia
sickle cell anemia
49
what is sickle cell anemia
severe anemia from an inherited sickle cell hemoglobin gene that causes abnormal shape to cell
50
what are the symptoms of sickle cell anemia
- RBC lifespan of 4-10 days - jaundice - tachycardia, murmurs, cardiomegaly, heart failure - pain - hypoxic damage
51
what are some complications of sickle cell anemia
- life expectancy - 50s - clots, CVA - sickle cell crisis
52
what is the treatment for sickle cell anemia
- stem cell transfusion - hydroxyurea (chemo drug) - blood transfusions - symptom management: hydration, oxygen, pain medication
53
what are the complications of anemia
- heart failure - chest pain - paresthesia - confusion - falls - activity intolerance | most complications come as a result of stress on the heart
54
describe nursing care for anemia
- manage fatigue - maintain nutrition - maintain perfusion - pt education - monitor for complications
55
your patient comes to the urgent care complaining of fatigue and a red smooth tongue. what lab value would be important to check?
iron *fatigue and smooth red tongue are symptoms of iron deficiency anemia*

adults (51 decks)

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