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Liz's Blood Bank Module 2 > Transfusion Therapy (Need to finish) > Flashcards

Transfusion Therapy (Need to finish) Flashcards

1
Q

List the signs and symptoms of anemia

A
  • Generalized weakness
  • Headache
  • Dizziness
  • Disorientation
  • Breathlessness
  • Palpitations
  • Chest pain
  • Pallor
  • Tachycardia
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2
Q

Transfusion of RBC products

- Primary indication

A

Anemia

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3
Q

Transfusion of RBC products

- Tests indicating transfusion is necessary

A
  • Hematocrit: ≤ 21%

- Hemoglobin: ≤ 7 g/dL

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4
Q

Transfusion of RBC products

- Expected rise in Hgb and hct values per unit of RBCs transfused

A

One unit should raise the hemoglobin by 1 g and hematocrit by 3%

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5
Q

Transfusion of RBC products

- Compatibility requirements

A

All red cell products MUST have some kind of XM (electronic, IS, or AHG)

  • ABO/Rh compatibility is REQUIRED
  • If whole blood is given, it must be ABO IDENTICAL
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6
Q

Transfusion of RBC products

- Contraindications to RBC transfusion

A

?

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7
Q

List red cell products

A
  • Leukoreduced packed cells
  • Washed packed cells
  • Frozen/deglyc’d packed cells
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8
Q

List indications of leukoreduced packed cells (LPC)

A
  • Febrile TX reactions
  • Prevention of HLA Abs
  • Oncology, transplant, neonate patients
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9
Q

List indications of washed cells (WC)

A
  • IgA deficient patients
  • EKMO patients/babies
  • Removal of anticoagulant or ↑ K+
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10
Q

List indications of frozen/deglyc’d cells (FC)

A
  • IgA deficient patients

- Rare phenotypes

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11
Q

Which blood product is capable of carrying CMV?

A

WBCs

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12
Q

Which blood products are capable of transmitting CMV?

A

RBCs and platelets

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13
Q

Which blood products are considered “CMV safe”, if CMV negative units aren’t available?

A

Leukoreduced and/or frozen/deglyc’d

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14
Q

Which 3 patient populations are at the highest risk for CMV infection if transfused w/ a CMV positive donor unit?

A
  • BM transplant patients
  • Infant/neonatal patients
  • Pregnant women
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15
Q

What is the purpose of irradiation of blood products?

A

?

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16
Q

List recipient conditions requiring irradiated blood components

A

?

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17
Q

Calculate the expiration date of irradiated blood products

A

?

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18
Q

Transfusion of platelet products

- Primary indication for transfusion/clinical symptoms

A
  • ↓ production
  • ↑ destruction
  • Splenic sequestration
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19
Q

Transfusion of platelet products

- Tests indicating transfusion is necessary

A
  • < 50,000/uL for “therapeutic” platelet TX

- 10,000-20,000/uL for patients w/ chemotherapy-induced thrombocytopenia

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20
Q

Transfusion of platelet products

- Expected rise in platelet count for transfused random platelets

A

Should increase platelet count by 5-10,000/uL for each unit

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21
Q

Transfusion of platelet products

- Expected rise in platelet count for transfused platelet pheresis (“single-donor platelets”)

A

Should increase platelet count by 20,000-60,000/uL

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22
Q

Transfusion of platelet products

- Compatibility requirements

A

ABO compatible preferred

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23
Q

Transfusion of platelet products

- Contraindications to platelets transfused

A

?

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24
Q

How is platelet transfusion effectiveness assessed?

A
  • Observation of stopped bleeding

- Look for refractoriness

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25
Q

Transfusion of granulocytes

- Primary indication for transfusion/clinical symptoms

A

Severe neutropenia (< 500/uL) and serious bacterial or fungal infection

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26
Q

Transfusion of granulocytes

- Compatibility requirements

A

ABO compatibility is required

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27
Q

Transfusion of granulocytes

- Effect of irradiation

A

RBCs become less contaminated?

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28
Q

Transfusion of plasma products

- Primary indication for transfusion/patient conditions

A

?

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29
Q

Transfusion of plasma products

- Tests indicating transfusion is necessary

A

PT/PTT > 1.5x reference range

30
Q

Transfusion of plasma products

- Compatbility requirements

A

ABO compatibility preferred

31
Q

Transfusion of plasma products

- Contraindications to a plasma transfusion

A

?

32
Q

____ is whole blood that was frozen w/in 8 hours of collection

A

FFP (fresh frozen plasma)

33
Q

____ is from whole blood frozen w/in 24 hours of collection

A

PF24 (plasma frozen w/in 24 hours)

34
Q

____ is plasma collected by apheresis

A

AFFP (apheresis fresh frozen plasma)

35
Q

____ is plasma left over after production of cryoprecipitate

A

CRP (cryo-reduced plasma)

36
Q

____ is derived from FFP and PF24 that has been thawed in a closed system

A

Thawed plasma

37
Q

Transfusion of cryoprecipitate

- Primary indication of transfusion

A
  • Fibrinogen (with/out active hemorrhage)
  • Factor XIII
  • Fibrin glue
  • von Willebrand’s disease
38
Q

Transfusionof cryoprecipitate

- Tests that indicate a transfusion is necessary

A
  • Fibrinogen deficiency: < 100 mg/dL

- Fibrinogen deficiency w/ hemorrhage: < 150 mg/dL

39
Q

Transfusion of cryoprecipitate

- Compatibility requirements

A

ABO compatibility preferred

40
Q

Transfusion of cryoprecipitate

- Contraindications to a cryoprecipitate transfusion

A

?

41
Q

Alternative treatments for cryoprecipitate products

A
  • Factor VIII concentrate
  • Factor IX concentrate
  • Novo Seven
  • Immune Globulins (IVIGs)
  • DDAVP
  • Iron therapy/vitamin B12/folic acid
  • EPO/Procrit
42
Q

Coagulation therapy for hemophilia A

A
  • Factor VIII
  • Novo Seven
  • DDAVP
43
Q

Coagulation therapy for hemophilia B

A
  • Factor IX

- Novo Seven

44
Q

Coagulation therapy for von Willebrand’s disease

A
  • Factor VIII

- DDAVP

45
Q

Coagulation therapy for Factor XIII deficiency

A

?

46
Q

Coagulation therapy for multiple coagulation deficiencies

A

FFP

47
Q

Coagulation therapy for liver failure

A

?

48
Q

Coagulation therapy for hypofibrinogenemia

A

Cryoprecipitate

49
Q

Coagulation therapy for TTP

A

FFP

50
Q

Why is Rh compatibility not important when choosing donor types for plasma product transfusions?

A

Does not contain RBcs or platelets

51
Q

Process of issuing blood to nursing unit or surgery

A
  • Transporter brings “pick-up slip”
  • Positive ID of recipient using two identifiers (name and MRN)
  • Dispense request sent to blood bank via computer
  • Blood product sent to unit via tube system
  • BB personnel review identifying info, inspect appearance of component, and ensure there’s a system to maintain proper storage during transport
52
Q

Appearance of bacterially contaminated unit

A
  • Purplish color above buffy coat (or cell/anticoag layer) or air seen in bag
53
Q

Proper labeling of unit

A
  • Tie tag or label must include: name, identifying # of intended recipient; component unit #; interpretation of compatibility tests if performed
  • Expiration date
54
Q

Corrective action if unit fails inspection

A

?

55
Q

Process of returning blood when TX delays are encountered or if blood isn’t used in surgery

A

Should be returned to blood bank for storage unless TX can be completed w/in 4 hours

  • Should not be left at RT ro stored in unmonitored fridge
  • Blood is viable only for 30 minutes if not issued in validated ice coolers
56
Q

Most important step to ensure safe transfusions?

A

PATIENT IDENTIFICATION

57
Q

Only acceptable additive solution to a unit of blood

A

Normal saline

58
Q

Maximum time that a unit can be transferred to a patient

A

4 hours

59
Q

Purpose of infusion sets

A

Retain blood clots and particles potentially harmful to recipient

60
Q

Purpose of blood warmers

A

Needed if cold blood is infused very rapidly (or in trauma settings) to reduce risk of cardiac arrest

61
Q

What patient population need blood warmers?

A
  • Patients w/ cold agglutinins

- Infant exchange TX

62
Q

Purpose of mechanical pumps

A

Deliver infusions at a controlled rate

63
Q

What patient population need mechanical pumps?

A

Peds and neonates

64
Q

Purpose of pressure devices

A

Infuse blood very rapidly most often in surgery

65
Q

How is a patient monitored during a transfusion?

A
  • Transfusionist should stay w/ patient for first 15 minutes (start w/ slow rate of 2mL/minute; severe rxns occur w/in first 25 mL)
  • Vital signs taken every 15 minutes; if all is good, increase rate to 4 mL/minute
  • Observe patient periodically throughout TX (~30 minutes) and up to 1 hour after transfusion
66
Q

What should be done when a potential transfusion reaction is suspected?

A

STOP THE TRANSFUSION and call the doctor immediately

67
Q

Which units are placed on the “Emergency Shelf” in most hospital blood banks?

A

2 units of O= and 2 units of O+

68
Q

In an emergency situation, give ____ to females of child-bearing age or males younger than 13 years old

A

O neg

69
Q

In an emergency situation, how is emergency blood released?

A

Physician must sign a release form

70
Q

Why does a neonate require less than 7 day old RBCs?

A

Reduces risk of hyperkalemia and maximize 2,3-DPG

Liz's Blood Bank Module 2 (8 decks)

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