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NSG 430 - Critical Care > T11: Blood Products & Transfusions > Flashcards

T11: Blood Products & Transfusions Flashcards

1
Q

Peripheral smear

A

morphology (SHAPE AND APPEARANCE) of blood cells

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2
Q

Pancytopenia

A

suppression of ALL (RBCs, WBCs, and platelets) blood cells

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3
Q

RBC count

A

3.8-5.7 X 10^6

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4
Q

Hemoglobin value (Hgb)

A

12-18 g/dL

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5
Q

Hematocrit value (Hct) determines

A

the percentage of RBCs compared to total blood volume

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6
Q

normal hematocrit levels

A

37-52%

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7
Q

what is the best indicator for anemia

A

hemoglobin and hematocrit

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8
Q

Erythrocyte sedimentation rate (ESR/Sed rate measures

A

sedimentation/settling of RBCs; tells us if inflammation is present

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9
Q

normal ESR

A

less than 20mm/hr

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10
Q

what WBC count is associated with infection

A

> 11,000/µL

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11
Q

normal WBC

A

5,000-10,000

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12
Q

Leukopenia is associated with WBC count of…

A

< 4000/µl

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13
Q

Differential count

A

% of each type of leukocyte

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14
Q

Absolute neutrophil count (ANC) is comprised of bands and segs ans tells us

A

there is an inflammatory response going on

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15
Q

Neutropenia is when the ANC is..

A

< 1000 cells/µL

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16
Q

Neutropenic precautions

A

(they have no immunity): ISOLATION, PPE, limiting visitors, no flower, no fresh fruit and veggies, when they go off the floor, put a mask on them when they are traveling, hand washing

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17
Q

Normal platelet count

A

150,000-400,000/µL

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18
Q

Thrombocytopenia

A

low platelet count; danger of spontaneous hemorrhage

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19
Q

Thrombocytosis

A

abnormally high platelet count; danger of excessive clotting

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20
Q

DIC is…

A

thrombocytopenia and thrombocytosis together; Bleeding and clotting at the same time

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21
Q

universal donor

A

O-

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22
Q

universal recipient

A

AB+

23
Q

Chelation therapy

A

a procedure in which excess metals, such as IRON, are removed from the blood

24
Q

what is used to treat anemias

A

Packed RBC/frozen

25
Q

what is used to treat thrombocytopenia

A

platelets

26
Q

Fresh frozen plasma is used for

A

o Bleeding-depleted clotting factors
o No platelets

27
Q

albumin

A

keeps fluid in the vessels (used for hypovolemia and hypoalbuminemia)

28
Q

Cryoprecipitate

A

o Clotting factors-Factor VIII, von Willebrand, fibrinogen
o Clotting factors for those with hemophilia (they have a hard time clotting)

29
Q

once a blood transfusion is ordered, what is needed?

A

-patient consent
-labs
-2 IV access

30
Q

why is 2 ive access needed

A

BLOOD NEEDS ITS OWN LINE

31
Q

prep and start the line with

A

0.9% normal saline ONLY

32
Q

TKO

A

to keep open (20-25mL of saline)

33
Q

once blood product is received what is needed

A

-2 RN check ALWAYS at bedside
- VS before starting-spike/start within 30 minutes

34
Q

start blood at

A

max of 2 mL/min (60-120mL/hr) for 15 minutes

35
Q

during the first 15 minutes

A

STAY WITH THE PATIENT, THEN REASSESS VS AFTER 15 MINS

36
Q

acute transfusion reactions usually occur

A

in the first 10-15 minutes or the first 50mL of blood

37
Q

Acute Hemolytic

A

in the moment happening now, breaking down the RBCs

38
Q

s/s of acute hemolytic

A

: fever, chills, low back pain, tachycardia, hypotension, hemoglobinuria, DARK URINE bleeding AKI, shock, DIC, death

39
Q

what is important to assess with acute hemolytic reaction

A

o CHECK THEIR URINE: may be brown color if kidneys are blocked off by clot

40
Q

Febrile Non-hemolytic

A

temp spike but it is not breaking down RBCs

41
Q

s/s of Febrile Non-hemolytic

A

o S/S: fever, chills, anxiety, headache, tachycardia, tachypnea

42
Q

intervention for Febrile Non-hemolytic

A

tylenol

43
Q

Mild allergic reaction s/s

A

o itchy, hives, rash, facial flushing, wheezing

44
Q

Mild allergic reaction intervention

A

o Antihistamine (Benadryl)

45
Q

anaphylactic s/s

A

BROCHOCONSTRICTION, ANGIOEDEMA, increased BP
o itchy, hives, rash, facial flushing, wheezing

46
Q

anaphylactic interventions

A

o Stop the transfusion
o Epinephrine, bronchodilators, steroids

47
Q

TACO

A

Transfusion Associated Circulatory Overload (basically ADHF FAST!)

48
Q

for TACO give

A

DIURETICS

49
Q

sepsis

A

if blood is hanging for too long or if the blood becomes too warm, bacteria can grow in it and cause sepsis

50
Q

TRALI

A

Transfusion Related Acute Lung Injury; Basically, their lungs are hemorrhaging (alveoli are filled with blood so no O2 and CO2 exchange ARDS)

51
Q

TRALI interventions

A

Immediately stop transfusion
-Chest x ray: pulmonary infiltrates
-Need aggressive support of therapy: need to be treated aggressively cause it can progress and be fatal VENT WITH PEEP

52
Q

INTERVENTION FOR REACTION

A

STOP TRANSFUSION AND OPEN UP THE FLUIDS

53
Q

MANAGEMENT OF TRANSFUSION REACTION

A
  • STOP TRANSFUSION
  • MAINTAIN PATENT IV LINE WITH 0.9% SALINE
  • NOTIFY THE BLOOD BANK AND THE HCP
  • RECHECK IDENTIFICATION TAGS AND NUMBERS
  • TREAT SYMPTOMS PER HCP ORDERS
  • SAVE THE BLOOD BAG, TUBING AND SEND TO BLOOD BANK
  • COLLECT REQUIRED BLOOD AND URINE SPECIMENS PER AGENCY POLICY
  • DOCUMENT ON TRANSFUSION REACTION FORM AND HER
  • THIS IS A SENTINAL EVENT: this could have killed them if we didn’t catch it
54
Q

Autologous blood product

A

o Planned predonated and stored (10 years frozen); donate their own blood

NSG 430 - Critical Care (42 decks)

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