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Exam 3 - AH > Transfusions > Flashcards

Transfusions Flashcards

1
Q

What are the 5 types of transfusions

A
  1. Homologous (Allogenic)
  2. Autologous
  3. Blood salvage
  4. Directed donor
  5. Artificial blood
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2
Q

What is the 5 criteria for blood donation

A
  1. healthy
  2. older than 17
  3. 110lbs and above
  4. Hgb 12.5g/dl for women and 13.5 for men
  5. <99.6 temp
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3
Q

How long can red blood cell donations be stored and at what temp?

A

42 days at 4* celsius

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4
Q

How long can platelet donations be stored and at what temp?

A

5 days at room temp

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5
Q

How long can fresh frozen plasma be stored and at what temp?

A

1 year and frozen

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6
Q

What is the normal lab values for hematocrit and hemoglobin including ratio?

A

HCT: 35-45% (males slightly higher)
HGB: 12-15 gm/dl (males slightly higher)

HCT : HGB = 3 : 1

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7
Q

What is the normal lab values for platelets?

A

150,000 - 350,000

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8
Q

What is the normal prothrombin time (PT) lab values?

A

9-11 seconds

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9
Q

What is the normal international normalised ratio (INR) lab values?

A

1

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10
Q

What is the normal partial thromboplastin time (PTT) lab value?

A

25-35 seconds

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11
Q

What are the two therapeutic effects of pRBC transfusion?

A

Increases O2 carrying capacity of blood and replaces blood loss

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12
Q

What are the indications (including lab values) of pRBC transfusion?

A

Active bleed
HCT <25% OR HGB <8 & symptomatic

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13
Q

What is the therapeutic effect of platelet transfusion?

A

increased thrombocytes (controls bleeding by replacing platelets)

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14
Q

What are the indications of platelet transfusion?

A

PLT < 50,000 and active bleed, or
PLT < 20,000

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15
Q

What is the therapeutic effect of fresh frozen plasma transfusion?

A

increased clotting factors

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16
Q

What are the indications for fresh frozen plasma transfusion?

A

INR >1.5 or PT>15 seconds or PTT>45 seconds

17
Q

What are the transfusion - disease contamination risks?

A

HIV, HCV etc e.g. zika virus?

18
Q

What are the 5reaction risk complications of transfusions?

A

Febrile: (temp increase >2deg)
Allergies: flushing, pruritis etc
Hemolytic: fever/chills, back pain, dark urine
Fluid overload
Sepsis

19
Q

What are the S/Sx of needing pRBC transfusion?

A

fatigue, weakness, tachycardia, pallor, low O2 sat, active bleed

20
Q

Explain type & cross procedure?

A

Type: blood type & Rh factor, expiration, client ID
Cross match: indirect coombs - want a negative

21
Q

How long is transfusion consent good for?

A

if outpatient - 1 year
if inpatient - duration of stay

22
Q

How may RN’s are required to sign out blood transfusion at bedside?

23
Q

What gauge IV is used for blood transfusion?

A

19 or 20 gauge is preferred

24
Q

What filtration is required for blood transfusion?

A

blood must be filtered using Y tubing with filter

25
Q

What is the timeframe for blood transfusion?

A

0-4 hours but generally is around 2 hours

26
Q

Explain key points for monitoring blood transfusion?

A

Start transfusion slow and stay for first 15 minutes

Vitals: take baseline vitals and at end

Temp: at 15 minutes (and ask about symptoms), then complete every hour

27
Q

What are the rules about blood transfusion delegation?

28
Q

What are the expected results for pRBC transfusion?

A

Increase of 3% HCT and 1gm HGB for each unit of blood

29
Q

When is blood drawn after blood transfusion to check results?

A

after 2-4 hours NOT earlier

30
Q

What happens if patient wants to go off unit during blood transfusion?

31
Q

What happens if blood transfusion pt only has one IV line but needs PCA and IV antibiotic?

32
Q

What happens if RN receives a call that blood transfusion pt needs MRI?

33
Q

How is a reaction to blood transfusion recognised?

A

fever: increase >2 deg (most reliable sign)

itching, rash, flushed face/chest, chest pain, tachy, hypotension

34
Q

Nursing intervention for blood transfusion reaction?

A
  1. STOP transfusion
  2. take down blood & tubing and replace with NS and new tubing
  3. blood sent back to blood bank
  4. call MD
  5. monitor VS
  6. direct coombs test (checks for hemolytic reaction)
35
Q

What is the expected lab response to platelet transfusion?

A

Increase of 5000 to 10,000 per unit of platelets (normally multiple units are given)

36
Q

What is the expected lab response to plasma transfusion?

A

INR: decrease (move towards normal)
PT: will decrease (clot quicker)
PTT: will decrease (clot quicker)

37
Q

Nursing interventions to speed up a slow transfusion?

A
  • hang blood higher
  • take blood down and gently agitate
  • flush IV and restart blood
  • use a pressure cuff
38
Q

Nursing interventions to minimise need for transfusion?

A

minimise bleeding risk: bedrest, bledsoe brace, no phlebotomy
rebuild blood: iron/folate/B12, epoiten alpha

Exam 3 - AH (5 decks)

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