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Pharmacology 2 > Transfusions > Flashcards

Transfusions Flashcards

1
Q

for each type of surgery, a max number of units that can be ordered for crossmatch are defined; prevents blood waste

A

maximum surgical blood order

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2
Q

how long are collected specimen good for?

A

72 hours

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3
Q

in which patients may antibodies be present in? (2)

A

past pregnancy
previously transfused

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4
Q

an antibody was found but we cannot find units lacking the antigen corresponding to that antibody. what can occur?

A

surgery may be delayed

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5
Q

when should we monitor / record vital signs when administering a transfusion?

A

prior to transfusion
15 mins
30 mins
every hour

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6
Q

adverse effects related to transfusions can be due to what products? (2)

A

cellular (RBCs)
plasma

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7
Q

an immediate intravascular hemolysis that is most often related to ABO incompatibility

A

acute hemolytic transfusion reaction (AHTR)

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8
Q

a patient begins to experience symptoms within 15 mins of transfusion. they feel pain at site, back pain, dread feeling, fever, chills, dyspnea, hypotension, increased pulse, and diffuse bleeding in a surgical field. what are they experiencing?

A

acute hemolytic transfusion reaction

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9
Q

what are 4 complications of an acute hemolytic transfusion reaction?

A

shock
renal failure
DIC
death

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10
Q

production of antibodies post-transfusion 2-14 days after.

A

delayed hemolytic transfusion reaction

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11
Q

a patient is asymptomatic but may have a fever and elevated bilirubin. what are they experiencing?

A

delayed hemolytic transfusion reaction

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12
Q

reaction of recipient antibodies to donor HLA antigens (on leukocytes and platelets)

A

febrile, non hemolytic transfusion reaction

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13
Q

a patient presents with fever, chills, headache, flushing, and rare muscle/chest pain. what are they likely experiencing?

A

febrile, non-hemolytic transfusion reaction

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14
Q

what can we give a patient before their transfusion to prevent a febrile, non-hemolytic transfusion reaction?

A

anti-pyretic

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15
Q

a patient presents with dyspnea, cyanosis, hypotension, hypoxemia, fever/chills, and pulmonary edema. what are they experiencing?

A

transfusion related acute lung injury

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16
Q

what is the onset of a transfusion-related acute lung injury?

A

4-6 hours post-transfusion

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17
Q

what is the treatment for a patient experiencing a transfusion-related acute lung injury?

A

oxygen / ventilation assistance

18
Q

what is contraindicated in a patient experiencing a transfusion related acute lung injury? (2)

A

diuretics
corticosteroids

19
Q

due to recipient antibodies to donor plasma proteins

A

allergic reaction

20
Q

a patient presents with urticaria, wheezing/dyspnea. what are they experiencing? what is the treatment?

A

allergic reaction
antihistamine

21
Q

recipient has antibodies to donor plasma IgA

A

anaphylactic reaction

22
Q

a patient presents with respiratory arrest and cardiac arrest. what are they experiencing?

A

anaphylactic reaction

23
Q

volume overload with pulmonary edema that occurs in elderly or neonates after a transfusion

A

transfusion associated circulatory overload

24
Q

a patient presents with hypertension, tachycardia, and respiratory distress. what are they experiencing? how should we treat it? (2)

A

transfusion associated circulatory overload

diuretics
oxygen

25
Q

occurs when bacterial endotoxins are in blood products, usually platelets and PRBCs

A

septic shock

26
Q

a patient presents with fever, chills, rapid heart/resp rate, hypotension, N/V, and bleeding that leads to DIC. what are they experiencing?

A

septic shock

27
Q

if a transfusion reaction is suspected, what should we send to the lab? (3)

A

new patient sample
blood bag + solutions
first post-transfusion urine

28
Q

which test identifies if antibodies are coating the RBCs?

A

direct antiglobulin test

29
Q

what are 3 mandatory tests if we suspect a transfusion reaction?

A

direct antiglobulin test

inspection of post-transfusion plasma for hemolysis

clerical check

30
Q

if a patient is in DIC, what blood products should be used?

A

fresh frozen plasma

31
Q

a 21 yo comes into the ER with a massive hemorrhage. we have difficulty stopping the bleeding due to large number of internal injuries. hemoglobin is at 4. what do we do?

A

massive transfusion protocol

32
Q

replacement of body’s blood volume within 24 hours

A

massive transfusion

33
Q

how many units are used in a massive transfusion?

A

over 20 units of PRBCs in 24 hours

34
Q

what is the replacement in a massive transfusion?

A

over 50% replacement within 3 hours

35
Q

if we have decreased volume in a patient, what do we give?

A

fluids - crystalloids or colloids

36
Q

if a patient has dilutional coagulopathy, what do we give?

A

fresh frozen plasma

37
Q

if a patient has dilutional thrombocytopenia, what do we give?

A

platelets

38
Q

if a patient has trouble with oxygen delivery, what do we give?

A

PRBCs

39
Q

a patient presents with signs of hemolysis, decreased platelet count, and schistocytes. what are they experiencing?

A

thrombotic microangiopathic hemolytic anemia (TMA)

40
Q

what is the treatment for thrombotic microangiopathic hemolytic anemia?

A

therapeutic plasma exchange (decrease antibodies)
+
caplacizumab OR rituximab

Pharmacology 2 (22 decks)

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