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adults > hematologic function and blood transfusion > Flashcards

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…

A

Hgb

25
Q

what does bone marrow need to make new RBCs

A

iron, B12, folate, B6 and protein

26
Q

describe the signs and symtoms of anemia

A

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
Q

diagnostics

erythrocytes

A

4.5 - 5.3 (men)
4.1 - 5.1 (women)

28
Q

diagnostics

hemoglobin

A

13 - 18 (men)
12 - 16 (women)

29
Q

diagnostics

hematocrit

A

40% - 50% (men)
38% - 48% (women)

30
Q

diagnostics

what is reticulocyte count

A

% immature RBCs in blood

31
Q

diagnostics

what is mean corpuscle volume

A

average size of a RBC

32
Q

serum b12 and folate are needed for…

A

hematopoiesis

33
Q

describe iron studies

A

evaluate iron metabolism and storage

34
Q

what are the different classifications of anemia

A

-hypoproliferative (not making enough or unhealthy shit)
-blood loss
-hemolytic (cells are destroyed)

35
Q

name different types of hypoproliferative anemia

A

-iron deficiency anemia
-anemia of chronic disease (normocytic)
-aplastic anemia
-megaloblastic anemia

36
Q

hypo-proliferative anemia

iron deficiency anemia

A

-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
Q

describe taking iron supplements

A

-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
Q

hypo-proliferative anemia

describe anemia of chronic disease (normocytic)

A

-caused by: chronic inflammation, chronic infection, malignancy
-symptoms: few (chronic) Hgb rarely >9
-treatment: treat underlying disease, supplements not beneficial

39
Q

hypo-proliferative anemia

describe aplastic anemia

A

-rare
-causes damage to stem cells and bone marrow, causing decreased RBC production
-treatment: stem cell transplant, immunosupression

40
Q

hypo-proliferative anemia

describe megaloblastic anemia

A

abnormally large RBCs due to lack of B12 or folate

41
Q

what are the symptoms of megaloblastic anemia

A
  • pancytopenia, abnormally shaped cells
  • low B12 may cause confusion, weakness, N/V, balance issues
42
Q

what are some risk factors of megaloblastic anemia

A

pregnancy, ETOH abuse, pernicious anemia

43
Q

what is the treatment for megaloblastic anemia

A

folate or B12 replacement, diet changes

44
Q

what is blood loss anemia caused by

A

caused by sudden loss of large volume of blood
(trauma, surgery, bleeding disorders)

45
Q

what is the treatment of blood loss anemia

A

-treat underlying condition
-transfuse PRBCs

46
Q

what is hemolytic anemia

A

-red blood cells have a shortened lifespan

47
Q

what are soe symptoms of hemolytic anemia

A

decreased O2 -> hypoxia -> stimulates erythropoietin -> release premature RBCs (reticulocytes) -> increased bilirubin -> jaundice

48
Q

name a type of hemolytic anemia

A

sickle cell anemia

49
Q

what is sickle cell anemia

A

severe anemia from an inherited sickle cell hemoglobin gene that causes abnormal shape to cell

50
Q

what are the symptoms of sickle cell anemia

A
  • RBC lifespan of 4-10 days
  • jaundice
  • tachycardia, murmurs, cardiomegaly, heart failure
  • pain
  • hypoxic damage
51
Q

what are some complications of sickle cell anemia

A
  • life expectancy - 50s
  • clots, CVA
  • sickle cell crisis
52
Q

what is the treatment for sickle cell anemia

A
  • stem cell transfusion
  • hydroxyurea (chemo drug)
  • blood transfusions
  • symptom management: hydration, oxygen, pain medication
53
Q

what are the complications of anemia

A
  • heart failure
  • chest pain
  • paresthesia
  • confusion
  • falls
  • activity intolerance

most complications come as a result of stress on the heart

54
Q

describe nursing care for anemia

A
  • manage fatigue
  • maintain nutrition
  • maintain perfusion
  • pt education
  • monitor for complications
55
Q

your patient comes to the urgent care complaining of fatigue and a red smooth tongue. what lab value would be important to check?

A

iron

fatigue and smooth red tongue are symptoms of iron deficiency anemia

adults (51 decks)

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