Hematologic System Flashcards
Whole Blood Administration
give over 2-4 hours
Whole Blood Indications
hemorrhage surgery trauma burns shock
Whole Blood Complications
acute hemolytic reaction fever anaphylactic reaction mild allergic reaction hypervolemia sepsis
Packed RBCs Administration
give over 2-4 hours
Packed RBCs Indications
severe anemia
hemoglobinopathies
hemolytic anemia
erythroblastosis fetalis
Packed RBCs Complications
acute hemolytic reaction fever anaphylactic reaction mild allergic reaction sepsis
Platelets Administration
give over 15-30 minutes
Platelets Indications
low platelet count active bleeding thrombocytopenia aplastic anemia bone marrow suppression
Platelets Complications
fever
sepsis
Fresh Frozen Plasma Administration
give over 30-60 minutes
Fresh Frozen Plasma Indications
replace clotting factors hemorrhage burns shock thrombotic thrombocytopenic purpura (TTP) reverse effects of warfarin
Fresh Frozen Plasma Complications
acute hemolytic reaction fever anaphylactic reaction mild allergic reaction hypervolemia sepsis
Pheresed Granulocytes Administration
Give over 45-60 minutes
Pheresed Granulocytes Indications
severe neutropenia
neonatal sepsis
neutrophil dysfunction
Pheresed Granulocytes Complications
acute hemolytic reaction fever anaphylactic reaction mild allergic reaction hypervolemia sepsis
Albumin Administration
5% 1-10 mL/min
25% 4mL/min
Albumin Indications
expand volume via oncotic changes hypovolemia hypoalbuminemia burns severe nephrosis hemolytic disease of newborn
Albumin Complications
hypervolemia
pulmonary edema
Blood Products Administration
Client ID, name, blood type must be verified by two nurses
must obtain baseline vital signs including temperature
must use 18- or 20- gauge catheter
use 0.9% NS to prime tubing
stay with client for first 15 minutes following administration
if reaction occurs: stop infusion, take vitals, infuse 0.9NS, call provider, send blood to lab for analysis
Epoetin Alfa Indications
stimulate RBC production
anemia related to chronic kidney disease, retrovir therapy, chemotherapy
Epoetin Alfa Complications
hypertension
Epoetin Alfa Administration
subcutaneous or IV
do not agitate vial
monitor Hgb and Hct
Filgrastim/Pegfilgrastim Indications
stimulate WBC production
neutropenia related to cancer
Filgrastim/Pegfilgrastim Complications
bone pain
leukocytosis
Filgrastim/Pegfilgrastim Administration
subcutaneous injection (filgrastim), IV (pegfilgrastim) do not agitate vial monitor CBC
Oprelvekin Indications
stimulate platelet production
thrombocytopenia related to cancer
Oprelvekin Complications
fluid retention
blurred vision
cardiac dysrhythmia
Oprelvekin Administration
administer within 6-24 hours after chemotherapy
subcutaneous injection
Iron preparations Administrations
dilute liquid preparations with juice or water and administer with plastic straw/syringe
encourage orange juice fortified with vitamin C (vitamin C facilitates absorption)
avoid antacids, coffee, tea, dairy products, whole grain breads concurrently or for 1 hr after administration
monitor for constipation and GI upset
for IM injection use Z-track, do not massage injection site, never use deltoid
for IV administration use test dose first
Anticoagulants Examples
Heparin Low molecular weight heparin (enoxaparin) warfarin dabigatran rivaroxaban
Heparin/Enoxaparin Indications
stroke pulmonary embolism deep vein thrombosis cardiac catheterization MI DIC
Warfarin Indications
venous thrombosis
prevent thrombus formation for clients who have atrial fibrillation or prosthetic heart valves
prevent recurrent MI
prevent transient ischemic attacks
Heparin/Enoxaparin Precautions
administer subcutaneously or IV
incompatible with many medications
avoid NSAIDs, aspirin, medications containing salicylates
Warfarin Precautions
Pregnancy Category X
contraindicated in thrombocytopenia, vitamin K deficiency, liver disease, alcohol use disorder
decreased effects with phenobarbital, carbamazepine, phenytoin, oral contraceptives
food high in vitamin K may decrease effects
Heparin/Enoxaparin Complications
hemorrhage
heparin induced thrombocytopenia
toxicity/overdose
Warfarin Complications
hemorrhage
toxicity/overdose
Heparin/Enoxaparin Administration
Heparin: monitor aPTT every 4-6 hours for IV administration
monitor for signs of bleeding, implement bleeding precautions
administer subcutaneous to abdomen, 2 inches from umbilicus, do not massage or aspirate
rotate injection sites and observe for bleeding or hematoma
administer protamine sulfate for toxicity
Warfarin Administration
administer once daily
monitor INR or PT
avoid NSAIDs and medications with aspirin
wear medical alert bracelet, bleeding precautions
administer vitamin K for toxicity
ginger, garlic, gingko, ginseng may increase risk of bleeding
avoid alcohol
Antiplatelets Examples
Aspirin Abciximab Clopidogrel Ticlopidine Pentoxifylline Dipyridamole
Antiplatelets Indications
prevention of acute MI or acute coronary syndrome
prevent stroke
intermittent claudication
Antiplatelets Precautions
contraindicated in thrombocytopenia
use caution in peptic ulcer disease
Antiplatelets Complications
prolonged bleeding
gastric bleeding
thrombocytopendia
Antiplatelets Administration
monitor for signs of prolonged bleeding
report tarry stool, ecchymosis
Thrombolytics Examples
Alteplase
Tenecteplase
Reteplase
Thrombolytics Indications
Acute myocardial infarction
deep vein thrombosis
massive pulmonary emboli
ischemic stroke
Thrombolytics Precautions
contraindicated in intracranial hemorrhage, active internal bleeding, aortic dissection, brain tumors
use caution with severe hypertension
concurrent use of anticoagulants or antiplatelet medications increases risk for bleeding
Thrombolytics Complications
serious bleeding risks from recent wounds, puncture sites, weakened vessels
hypotension
possible anaphylactic reaction
Thrombolytics Administration
administration must take place within 4-6 hrs of onset
continuous monitoring is acquired
clients will begin anticoagulant therapy to prevent repeat thrombotic event
