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Brandon’s AFN Health Assessment > Hematology II > Flashcards

Hematology II Flashcards

1
Q

What is major reason for transfusion of PRBCs in the OR?

A

improve oxygen caring capacity

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2
Q

Hgb 7-8 do you tranfuse?

A
  1. If undergoing ortho or cardiac surgery
  2. if have stable cardiovascular disease, after doing clinical evaluation
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3
Q

When do we transfuse pt with Hgb 8-10?

A

symptomatic anemia
ongoign bleeding
ACS with ischemia
hematology/oncology pt with severe thrombocytopenia

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4
Q

What is type and screen?

A

test patients blood for Rh factor, and wha antibodies they have

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5
Q

What is type and cross?

A

type and screen and then you cross match it with blood > tag it and set aside for patient

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6
Q

O type blood has what antigens? and what antibodies?

A

No antigens
Anti-a & anti-b antibodies

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7
Q

What blood can someone with O type receive?

A

O blood

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8
Q

Type A blood has?

A

A antigen
anti-B antibody

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9
Q

What blood can someone with type A receive?

A

Type O
Type A

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10
Q

Type B blood has?

A

B antigen
anti-a antibody

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11
Q

What blood can someone with type B receive?

A

type b
type O

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12
Q

What blood can someone with type AB receive?

A

O
A
B
AB

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13
Q

T/F Rh+ can receive Rh- but not the other way around?

A

true

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14
Q

AB type blood has what antibodies?

A

none. no antibodies

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15
Q

Universal Donor?

A

O-

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16
Q

Universal recepient?

A

AB+

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17
Q

antigen

A

marks the blood cell

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18
Q

antibodies

A

attack and destroy other blood cells

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19
Q

sx of acute hemolytic transfusion reaction

A

fever, chills, flushing
chest/flank/back pain
hypotn
oliguria or anuria or hemoglobinuria
diffuse bleeding out of IVs and tubes

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20
Q

tx for acute hemolytic transfusion rxn

A
  1. stop transfusion
  2. keep uop 75-100 ml/hr
  3. assay urine and plasma for hgb [ ]
  4. return unused blood to the blood bank
  5. prevent hypotension
  6. recheck labelling
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21
Q

your patient is under anesthesia and you gave blood, what are some signs that your patient is having an acute hemolytic transfusion rxn

A

increased T
unexplained tachycardia
hypotension
hemoglobinuria
bronchospasm
diffuse oozing in surgical field

22
Q

what are hemolytic transfusion rxns due to

A

ABO incompatability

23
Q

_________ is a transfusion reaction with a mild reaction, typically with re-exposure d/t Ab to non-D antigens

A

hemolytic

24
Q

sx of hemolytic transfusion reaction

A
  1. clinical low grade fever
  2. mild jaundice
  3. unexpected drop in hgb
25
Q

how do you manage transfusion reaction?

A

supportive therapy:
1. monitor hgb
2.hydration
3. tranfuse if hgb too low

26
Q

what causes febrile non hemolytic transfusion reaction?

A

typically due to multiple transfusions which leads to the development of alloantibodies on donated blood WBC

27
Q

most common transfusion reaction?

A

febrile non hemolytic transfusion reaction

28
Q

sx of febrile non-hemolytic transfusion reaction

A
  1. fever.chills
  2. respiratory depression
  3. anxiety
    4.headache
  4. myalgia
29
Q

what is the treatment for a febrile non-hemolytic transfusion reaction?

A

tylenol

30
Q

RALi within 6 hours of tranfusion you will have what sx?

A

dyspnea
chills/fever
bilateral pulmonary edema
significant pulmonary compromise > intubation
hypotension in cardiac patients

31
Q

TRALI treatment?

A

stop transfusion
O2/ventilation > low Tidal Volume

32
Q

indications to transfuse PRBC?

A

symptomatic anemai
Hbg<6 if healthy
massive hemorrhage
decreased O2 carrying capacity

33
Q

how long to platlets last normally? if donated?

A

7-10 days
4-5 days

34
Q

I unit of platelets should increase plt count by

A

30,000-60,000

35
Q

home many plateletpheresis packs per 10kg of weight?

A

one

36
Q

T/F plt have to be ABO compatible?

A

false, preferred but not required

37
Q

contents in plts?

A

plts and clotting factors

38
Q

plt transfusion triggers

A
  1. active bleeding with bleedign time 2x normal
  2. active bleeding with plt < 20,000
  3. active bleeding with bleeding time < 60,000 for surgical pts
  4. active bleeding after complete heparin neutralization (post ECC bypass)
39
Q

For CNS procedure give plts if they are < ?

A

100,000

40
Q

FFP must be ABO compatible?

A

True

41
Q

contents in FFP?

A

all coagulation factors (especially II, VII, IX, and X)
protein C
protein S
antithrombin III

42
Q

for every 3 UPRBC you should give how many FFP?

A

one

43
Q

for every 3 UPRBC you should give how many FFP?

A

one

44
Q

if massive tranfusion protocol, normally you give __ FFP for every ___ PRBC?

A

1:1

45
Q

Indications to give FFP

A

bleeding from warfarin therapy
massive transfusion/coagulopathy
coagulation factor deficiency
Antithrombin III deficiency
correction of multiple coagulation deficits
correction of microvascular bleeding w/ abn coags
give if entire blood volume has been tx

46
Q

10 - 15 ml/kg of FFP should increase clotting factors by ______________%

A

20-30

47
Q

FFP in NOT indicated for

A

PT, INR, or aPTT that is normal
solely for augmentation of blood volume or albumin [ ]

48
Q

1 “pool” of cryoprecipitate will increase fibrinogen ______________

A

45 mg/dL

49
Q

____________________ is a concentrated version of FFP

A

cryoprecepitate

50
Q

T/F: cryoprecipitate must be ABO compatible

A

false, preferred but not required

51
Q

cryoprecipitate product content

A

fibrinogen
factors V, VIII, and XIII and vWF

52
Q

when do you transfuse cryo

A

hypofibrinogenemia (<80-100)
massive hemorrhage
bleeding pts with vWD, unresponsive to DDAVP
tx of microvascular bleeding with fibrin deficicency

Brandon’s AFN Health Assessment (17 decks)

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