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Intro To Nurse Anesthesia > IV fluids and blood component therapy > Flashcards

IV fluids and blood component therapy Flashcards

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1
Q

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

A

intracellular fluid

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2
Q

where is a large amount of intracellular fluid found?

A

skeletal muscle

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3
Q

extracellular fluid:

A

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

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4
Q

two types of extracellular fluid

A

intravascular volume
interstital volume

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5
Q

intravascular volume:

A

plasma portion of blood
4.3% of BW or 3L

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6
Q

interstitial volume:

A

fluid between the cells
15.7% BW or 12L

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7
Q

EBW for average adult male

A

70 ml/kg

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8
Q

EBW for average female

A

65 ml/kg

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9
Q

EBW for obese patients

A

55 ml/kg

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10
Q

formula for fluid replacement:

A

deficit + maintenance + insensible +blood loss =hourly replacement

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11
Q

how to calculate EBV

A

EBW x KG

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12
Q

how much crystalloid would you give for 1 ml blood loss

A

3 ML

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13
Q

how much colloid would you give for 1 ml blood loss

A

2ml

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14
Q

how much blood would you give for 1 ml blood loss

A

1 ml

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15
Q

lap sponges hold how many CC of blood

A

100-150 ml

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16
Q

minimal moderate and extreme insensible loss:

A

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

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17
Q

how to calculate the deficit:

A

multiply number of hours NPO by maintenance

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18
Q

two ways to calculate the allowable blood loss

A

20% of EBV or

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

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19
Q

what causes the transfusion reactions

A

antibodies

20
Q

type A blood type

A

antigen A and Anti-b antibodies

21
Q

type B blood type

A

antigen B and anti-a antibodies

22
Q

type AB blood type

A

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

23
Q

type O

A

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

24
Q

what antigen determines RH - or +

A

D antigen

25
Q

most severe reactions are ____ incompatibility

A

ABO

26
Q

what are the 3 functions of a crossmatch

A

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

27
Q

use of whole blood:

A

acute blood loss, has plasma which gives more volume

28
Q

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

A

PRBC

29
Q

each unit of FFP will increase your clotting factor by :

A

2-3%

30
Q

each unit of platelets will increase amount by ___

A

5,000-10,000

31
Q

destruction of transfused RBC by patients antibodies

A

hemolytic reaction

32
Q

what is an acute (intravascular) hemolytic reaction

A

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

33
Q

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

A

chills, nausea, chest pain, flank pain

increase temp, increased HR, decrease BP, hemoglobinuria, oozing, DIC shock, renal failure

34
Q

treatments for an acute hemolytic reaction

A

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

35
Q

what is a delayed (extravascular) hemolytic reaction

A

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

36
Q

s/s of delayed hemolytic reaction

A

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

37
Q

what is a non-hemolytic reaction

A

febrile- 1-3% of transfusions

history of febrile reaction- give white cell poor transfusion

38
Q

uticarial reaction

A

hives, itching, no fever

treat with benadryl

39
Q

anaphylactic reactions

A

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

40
Q

what is a transfusion related acute lung injury (TRALI)

A

form of noncardiac pulmonary edema
occurs within 6 hours of transfusion

41
Q

what is transfusion associated circulatory overload (TACO)

A

leading transfusion related risk for trauma patients

increase in volume in circulation leading to pulmonary edema and decreased functional residual capacity

42
Q

types of viral infectious complications

A

hep C- most symptomatic
hep A
hep B
AIDS

43
Q

types of bacterial infectious complications

A

staph
citrobacter

44
Q

what is a massive blood transfusion

A

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

45
Q

what is citrate toxicity

A

CA binding by citrate present

s/s decrease Ca, decrease BP, increase CVP, long QT, decrease Mag

46
Q

___ blood decreased chance of infection or transfusion reaction

A

autologous blood

47
Q
A

Intro To Nurse Anesthesia (4 decks)

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