IV fluids and blood component therapy

Question 1

makes up approximately 30-40% of body water or 28 L

Answer 1

intracellular fluid

Question 2

where is a large amount of intracellular fluid found?

Answer 2

skeletal muscle

Question 3

extracellular fluid:

Answer 3

body water outside cells 20-25% BW or 15L

Question 4

two types of extracellular fluid

Answer 4

intravascular volume
interstital volume

Question 5

intravascular volume:

Answer 5

plasma portion of blood
4.3% of BW or 3L

Question 6

interstitial volume:

Answer 6

fluid between the cells
15.7% BW or 12L

Question 7

EBW for average adult male

Answer 7

70 ml/kg

Question 8

EBW for average female

Answer 8

65 ml/kg

Question 9

EBW for obese patients

Answer 9

55 ml/kg

Question 10

formula for fluid replacement:

Answer 10

deficit + maintenance + insensible +blood loss =hourly replacement

Question 11

how to calculate EBV

Answer 11

EBW x KG

Question 12

how much crystalloid would you give for 1 ml blood loss

Answer 12

3 ML

Question 13

how much colloid would you give for 1 ml blood loss

Answer 13

2ml

Question 14

how much blood would you give for 1 ml blood loss

Answer 14

1 ml

Question 15

lap sponges hold how many CC of blood

Answer 15

100-150 ml

Question 16

minimal moderate and extreme insensible loss:

Answer 16

4ml/kg/hr
6 ml/kg/hr
8 ml/kg/hr

Question 17

how to calculate the deficit:

Answer 17

multiply number of hours NPO by maintenance

Question 18

two ways to calculate the allowable blood loss

Answer 18

20% of EBV or

calculate EBV x (hemoglobin initial - hemoglobin allowable (bleed out) dividied by hemoglobin initial

Question 19

what causes the transfusion reactions

Answer 19

antibodies

Question 20

type A blood type

Answer 20

antigen A and Anti-b antibodies

Question 21

type B blood type

Answer 21

antigen B and anti-a antibodies

Question 22

type AB blood type

Answer 22

antigens A and B, neither anti-a or anti-b antibodies

Question 23

type O

Answer 23

neither antigen A or B, both anti-A and Anti-B antibodies

Question 24

what antigen determines RH - or +

Answer 24

D antigen

Question 25

most severe reactions are ____ incompatibility

Answer 25

ABO

Question 26

what are the 3 functions of a crossmatch

Answer 26

confirm ABO/Rh detects antibodies to other blood groups detects antibodies in low titers

Question 27

use of whole blood:

Answer 27

acute blood loss, has plasma which gives more volume

Question 28

good for RBC bu tnot for volume, must add NS for volume, should warm before, each unit increased hgb by 1

Answer 28

PRBC

Question 29

each unit of FFP will increase your clotting factor by :

Answer 29

2-3%

Question 30

each unit of platelets will increase amount by ___

Answer 30

5,000-10,000

Question 31

destruction of transfused RBC by patients antibodies

Answer 31

hemolytic reaction

Question 32

what is an acute (intravascular) hemolytic reaction

Answer 32

secondary to ABO incompatibility caused by misidentification of patient, specimen, or unit often a severely fatal reaction

Question 33

s/s of an awake patient vs a patient under anesthesia for an acute hemolytic reaction

Answer 33

chills, nausea, chest pain, flank pain increase temp, increased HR, decrease BP, hemoglobinuria, oozing, DIC shock, renal failure

Question 34

treatments for an acute hemolytic reaction

Answer 34

stop transfusion administer O2 recheck unit of blood get blood specimen from patient insert foley give a lot of fluid and mannitol and possibly low dose dopamine (to perfuse kidneys) may also need platelets

Question 35

what is a delayed (extravascular) hemolytic reaction

Answer 35

usually mild- from antibodies takes weeks to months to form (usually 2-21 days after transfusion) caused by re-exposure to same antigen

Question 36

s/s of delayed hemolytic reaction

Answer 36

malaise, jaundice, fever, increase biliubin level just monitor-treatment

Question 37

what is a non-hemolytic reaction

Answer 37

febrile- 1-3% of transfusions history of febrile reaction- give white cell poor transfusion

Question 38

uticarial reaction

Answer 38

hives, itching, no fever treat with benadryl

Question 39

anaphylactic reactions

Answer 39

RARE only need a few ml of blood to get a reaction treat with epi, fluids, steroids

Question 40

what is a transfusion related acute lung injury (TRALI)

Answer 40

form of noncardiac pulmonary edema occurs within 6 hours of transfusion

Question 41

what is transfusion associated circulatory overload (TACO)

Answer 41

leading transfusion related risk for trauma patients increase in volume in circulation leading to pulmonary edema and decreased functional residual capacity

Question 42

types of viral infectious complications

Answer 42

hep C- most symptomatic hep A hep B AIDS

Question 43

types of bacterial infectious complications

Answer 43

staph citrobacter

Question 44

what is a massive blood transfusion

Answer 44

1-2 x patient blood volume or 10 or more units

Question 45

what is citrate toxicity

Answer 45

CA binding by citrate present s/s decrease Ca, decrease BP, increase CVP, long QT, decrease Mag

Question 46

___ blood decreased chance of infection or transfusion reaction

Answer 46

autologous blood