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Test 2 > Paternal Fluids and Blood products > Flashcards

Paternal Fluids and Blood products Flashcards

1
Q

what are crystalloids

A

small molecules that

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2
Q

cystalloids

A

that flow from vascular to interstitial

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3
Q

________solution has the same osmolality as plasma

A

isotonic solution

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4
Q

what is the osmolality of an isotonic solution

A

280-300

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5
Q

In an isotonic solution fluid mainly stays in the

A

ECF

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6
Q

Name Isotonic solutions

A

NS=NaCl .9%=free water and no calories

Lr(Na, Cl, K, Ca, lactated ringers)

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7
Q

A ______solution has a lower osmolality than normal plasma.

Water is pulled from ________to _________.

A

hypotonic solution=lower osmolality

moves from vessels to cells

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8
Q

A type of hypotonic solution is

A

1/2 NS=.45% NaCl

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9
Q

Describe a fluid shift in an hypertonic solution

A

fluid shifts from intracellular to extracellular

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10
Q

Colloids are _____molecular weight made of ____and _____.
They remain in the _______space.
They pull fluid from _______ and ___________ space.
They are known as ___________.
Types include:

A

Colloids are ___high__molecular weight made of starch and proteins.
They remain in the intravascular space.
They pull fluid from intracellular and interstitial space.
They are known as volume expanders.
Types include: Albumin, Dextrose, Hespan, Plasma protein factors

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11
Q

What are some benefits of using albumin?

A 
Derived from plasma
heat treated
No ABO antibodies
no transfusion reaction risk
no Hep or HIV transmission
remains in vascular longer
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12
Q

What is something that must be watched when using albumin?

A

it stays in the vascular longer so you must watch for fluid volume overload

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13
Q

Describe Albumin 5%

A
  • 5 gm/100 ml
  • isotonic solution
  • maintains COP
  • used for rapid volume expansion
  • give 2-4 ml/min
  • comes in 250-500ml
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14
Q

Descrive Albumin 25%

A
  • hypertonic
  • expands volume 4-5 times the volume infused
  • shift from interstitum to intravascular
  • give 1 ml-minte to prevent rapid shift
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15
Q

Albumin 25% is commonly used for

A

burn patients

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16
Q

Indications of using albumin

A

volume expanders-> surgery, burns, and trauma
volume expander->patient who is waiting for T & C for blood
blood pressure support

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17
Q

Albumin is contraindicated in these patients

A

in anemic patients-may dilute more

dehydration-pulling fluid from cells further dilutes us

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18
Q

Antigens in Blood

A

ABO blood group
Rh factor
Human Leukocyte antigen

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19
Q

what is a type and screen

what is a type and Cross

A

type and screen is when general antibody info is needed

type and cross is when pts blood is crossed w/ someone else’s and try to match as many antibodies as possible

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20
Q

People with type A blood have
antibodies-
donate to-
receive from-

A

anti B antibodies
give to A and AB
receive from A and O

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21
Q

People with type B blood have
antibodies-
donate to-
receive from-

A

antibodies: Anti A
give to B and AB
recieve from B and O

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22
Q

People with type AB blood have
antibodies-
donate to-
receive from-

A

antibodies-none
give to no one
receive from A,B,AB, and O

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23
Q

Rhesus Antigen Rh antibody in______.
1st exposure
2nd exposure

A

RBC
1st exposure-sensitizes
2nd- exposure is possible fatal

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24
Q

Human Lekocyte antigen are on _________

responsible for________during_______

A

platletes, WBC, and tissue cells

febrile reaction during transfusions-causes platlette destruction

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25
Q

what kind of people will benefit from HLA testing

A

people who receive many transfusions over time

those who receive transfusions over a short period of time

26
Q

Whole Blood contains

A

RBC, platelettes, and plasma

27
Q

when is whole blood used

A

used for massive hemmorage where more than 25% of the blood volume has been lost

28
Q

Whole Blood comes in _____units

A

500 ml units

29
Q

when giving whole blood you can expect Hg to go up ____ and HCT up to _____

A

Hg by 1 gm

and HCT by 3-4%

30
Q

Packed Red Blood Cells are formed by taking____ml of ____
same _____count as whole blood
_____viscosity-use______to dilute

A

250 ml of plasma
same RBC count as whole blood
High viscosity use NS dilute

31
Q

why would we use PRBC

A

TO IMPROVE OXYGEN CARRYING CAPACITY
IMPROVE COLLOIDAL ONCOTC PRESSURE
STILL IRON IN THIS

32
Q

what is leukocyte depleted blood

A

leukocytes removed by filtration

33
Q

why would we use leukocyte depleted blood

A

on patients that have a history of febrile transfusions
immunocompropised
multiple transfusions over time

34
Q

how are platlettes given?
Random donor Vs. Single donor
uses

A

platelettes are given in 30-50 ml/unit–IV bolus with a special filter

random donor comes from 6-10 people -increase plt count by 10,000–> increased risk of allergic reaction

single donor-increase platless by 60,000–>less risk of allergic reaction

35
Q

why would someone need a platlett transfusion?

A

Control bleeding
DIC
Thrombocytopenia-unless it is ideopathic in this case platelet transfusion will not do any good-tear up platelets

36
Q

Fresh frozen plasma contains
must be______
uses__-_______

A

clotting factors, fibrinogn–NO PLATELETS
must be thawed
uses for clottingfactors
IC, hemmorage, liver disease, reverse coumadin effects

37
Q

i someone is getting FFP we need to wath for

A

fluid overload

Hypocalcemia-the citric acid that preserves blood binds with CA

38
Q

cryoprecipitate contains factors
can give______ @______
used for

A

factors VIII Factor XIII, and fibrinogen
6-10 units
can give rapidly10 ml/min

used for: hemophilia A, DIC, Von Willie Brands Disease

39
Q

wht kind of iv must be used to hang blood

A

18-20 gauge=large so blood w/ not be damaged

central line is preffered

40
Q

blood can only be administered with

A

NS

do not mix anything else

41
Q

Blood must be identified by

A

2 licensed nurses

42
Q

after giving blood nurse must stay with patient for

A

15 minutes

43
Q

blood must be given with ____ time from getting on the unit

A

30 minutes

44
Q

blood is to be given at a rate of

exception:

A

1 unit over 2 hours

exception is for trauma patients

45
Q

change tubing on blood q

A

every 4 hours or 2 units

46
Q

blood can not hang more than

A

4 hours

47
Q

what is the first action if reaction is suspected

A

stop the infusion ****

48
Q

Transfusion reaction

A 
stop
call dr
keep iv NS, replace tubing
give blood tubing to lab
investigation reports
49
Q

what is endogenous

A

-my body does not like it
causes:antigen-antibody reactions
allergic
bacterial contamination
plasma protein incomptibility
febrile
hemolytic iiiii

50
Q

Alergic Reaction==> CAUSE, Symptoms, Treatment

A

causes from allergen from blood

symptoms aare-AFN-anaphylaxis, fever, nausea/vomit

51
Q

Endogonous-bactrial contamination
caues
symptoms
treatment

A

cause is organism survives the cold Pseudo and Staph

Symptoms: abdominal cramps, fever, chills, nausea, diarrhea, shock

Treatment: stop dr, antibiotics, epi, corticosteroids

52
Q

febrile reaction from ________
causes
symptoms
treatment

A

reaction to leukocytes, platelets or plasma proteins

symptoms: chest tightness, flank pain, fever, chlls, increased heart rate

53
Q

Hemolytic reaction
causes
symptoms
treatment

A

causes: ABO or rh incompatible—severe and immediate
symptoms: BURN ALONG INFUSION LINE*****OOZING, DYSPNEAA, FLANK PAIN, CHEST PAIN, DECREASED BP IS A LATER SIGN

Treatment: stop, dr, o2, fluids, epi, monitor DIC and renal filure

54
Q

how can we ck for a hemolytc anemia

A

flush with saline if it still burns it is blood if not it is IV

55
Q

Plasma Protein Incompatibilty

A

cause is immunoglobin A incomp

symptoms:abdominal pain, fever,chills, dyspnea, later decreased BP

treament
stop
dr
oxygen fluids, epi, corticoids

56
Q

Exogenous Reactions

A

externl factors in administration of blood

  • bleeding tendency
  • hypothermia
  • ciculatory overload
  • hypocalcemia
  • hyperkalemia
57
Q

Bleeding Tendencies is a _______
cause
symptoms
Treatment

A

Bleeding Tendencies is a exogenous reaction=blood dont like me
cause: decreased latelet ct in stored blood
symptoms:blleding, bruising, oozing
Treatment: physician, platelets, FFP,Cyroprecipitate, monitor platelet ct

58
Q

circulatory overload is _______reaction
cause:
Symptoms:
Treatment:

A

circulatory overload is Exogenous reaction
cause: too rapis infusion
Symptoms: dyspnea, crackles, JVD, HTN, tachy
Treatment: dr, stop, diuretics, monitor Vs, and o2

59
Q

Hyperkalemia is_______
cause:
symptom:
treatment:

A

Hyperkalemia is an exogenous

cause: increased potassium in stored plasma by lysis of RBC
symptom: brady and peaked T waves
treatment: dr,12 lead, elec levels, kayexalate, glucose, insulin, hydrate

60
Q

Hypocalcemia is:
cause:
symptom:
treatment:

A

Hypocalcemia is exodogenous
cause: citrate-treated blood binds w/ ca
symptoms: arrythmias, decreased BP, muscle cramps, tingling
Treatments: Dr. Stop/slow,calcium gluconate

61
Q

Hyppothermia is_______

A

hypothermia is a exogenous reaction

cause: rapis infusion of lg amounts of blood
symptoms: slow or stop infusion
treatment: warm pt w/ blankets, blood warmer is hardly used

Test 2 (11 decks)

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