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Nursing 172 > Week 9: Treas pg 1490-1492, Replacement of Blood + Blood Products > Flashcards

Week 9: Treas pg 1490-1492, Replacement of Blood + Blood Products Flashcards

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1
Q

What does not restore oxygen-carrying capacity or replace clotting factors?

A

IV fluids

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2
Q

When are Blood products infused?

A

infused when the patient has experienced significant blood loss, diminished oxygen-carrying capacity., or a deficiency in one of the blood components

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3
Q

How is donated blood separated?

A

each unit of donated blood is separated into multiple components, such as RBCs, plasma, platelets, and clotting factors
-thus, one unit of donated blood may be used in the care of 4 patients

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4
Q

What you need to be eligible to donate blood?

A

a person must be in good health, at least 16 years old, and weigh at least 110 lbs
-each potential donor is screened for travel to certain countries and for a variety of disorders (HIV, hepatitis, or “mad cow’s” disease)

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5
Q

Blood Groups: 4 main groups

A

A, B, AB, O

based on the presence or absence of certain antigens and antibodies

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6
Q

Antigen

A

proteins that illicit immune response

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7
Q

Antibody

A

protects the body from “invaders”

-tells the blood/body what to destroy

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8
Q

Why do you not want to have the same antigen and antibody?

A

because it will attack itself

  • AB= no antibodies, A + B antigens
  • A= B antibodies, A antigens
  • B= A antibodies, B antigens
  • O= A+B antibodies, no antigens
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9
Q

AB blood type is considered what?

A

universal recipient

-because of the absence of plasma antibodies

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10
Q

O blood type is considered what?

A

universal donor

-because of the absence of antigens

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11
Q

Rh Factors

A

an additional antigen that is important in blood typing
-if the antigen is present you are Rh-positive (Rh+)
-if the antigen is absent you are Rh-negative (Rh-)
>8 groups: ARh+, Arh-, BRh+, BRh-, ABRh+, ABRh-, ORh+, ORh-
>people who are Rh+ may receive blood with or without Rh factor
>people who are Rh- ay receive only Rh- blood

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12
Q

Sequence of what happens once blood is donated

A

several tests are performed on the sample
-first, the sample is tested for ABO group (blood type) and RH type (+ or -) as well as any unexpected RBC antibodies that may cause problems in a recipient
-Screening Tests–> assess for evidence of donor infection with hepatitis B and C viruses, HIV, human T-lymphotropic viruses, West Nile virus, and syphillis
>if all disease screenings are negative, the blood is acceptable for transfusion and is placed in the pool of available products

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13
Q

When a potential donor is identified what process if performed?

A

crossmatching

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14
Q

Crossmatching

A

identifies possible minor antigens that will affect the compatibility of the donor blood in the recipient

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15
Q

Process of Crossmatching

A

RBCs from the donor blood are mixed with plasma from the potential recipient
-a reagent is added, and the sample is observed for clumping or agglutination; if no clumping is observed, the risk of transfusion reaction is low, and it is safe to transfuse the sample of blood

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16
Q

Autologous

A

(self-donated)

  • when possible, self donated units of blood are given instead of blood from a donor
  • this negates the risk of a mismatch or exposure to undetected disease
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17
Q

Process of Autologous donation

A

the patients blood is usually collected in the pre-operative weeks for possible transfusion during elective surgery

  • autologous donation is most often done with orthopedic, cardiac, and vascular surgeries
  • the process of donating autologous blood stimulates the bone marrow to produce new blood cells
  • given adequate time for recovery, the collected cells may be wholly or partially replaced prior to surgery
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18
Q

Blood Products: Several Blood products are available for transfusion

A
  • Whole Blood
  • RBC
  • Platelets
  • Plasma
  • WBC
  • Plasma Derivatives
19
Q

Blood Products: Whole Blood

A

contains RBCs, WBCs, and platelets suspended in plasma

20
Q

Blood Products: RBC

A

prepared from whole blood by removing the plasma

  • RBCs can raise the clients hematocrit and hemoglobin levels while minimizing an increase in volume
  • RBCs are available for transfusion as packed RBCs (PRBC)
21
Q

Blood Products: Platelets

A

help the clotting process by sticking to the lining of blood vessels

  • units of platelets are prepared by using a centrifuge to separate the platelet-rich plasma from the donated unit of whole blood;
  • the platelet rich plasma is then centrifuged again to further concentrate the platelets
  • platelets are used to treat clients who have a shortage of platelets or have abnormal platelet function
22
Q

Blood Products: Plasma

A

is the liquid portion of the blood

  • it is 90% water and makes up about 55% of blood volume
  • plasma may be transfused whole or may be separated into specific products such as albumin, clotting factor concentrates, and immune globulins
23
Q

Blood Products: WBC

A 
specifically granulocytes (neutrophils, eosinophils, or basophils) can be collected by centrifugation of whole blood
-they are transfused within 24 hours after collection and are used for infections that are unresponsive to antibiotic therapy
24
Q

Blood Products: Plasma Derivatives

A

are concentrates of specific plasma proteins prepared from many units of plasma
-plasma derivatives include a variety of clotting factors, immune globulins, and albumin

25
Q

What to do before beginning a transfusion?

A

verify the written prescription for the blood product

-it is critical to identify the patient and the blood product when transfusing blood

26
Q

What to do when initiating a transfusion?

A
  • obtain a set of vital signs 5 to 15 minutes before initiating a transfusion
  • inspect the IV site to be sure it is patent before hanging the blood product
27
Q

Rationale for: Obtain a set of vital signs 5 to 15 minutes before initiating a transfusion

A

if a patients temperature is elevated, inform the primary care provider before hanging the transfusion

  • most patients experience a minor elevation in temperature after a transfusion is given
  • a preexisting elevated temperature may exacerbate this response; as a result, premedication may be prescribed
28
Q

Rationale for: Inspect the IV site to be sure it is patient before hanging the blood product

A

nurses commonly use a 20-gauge catheter to infuse blood- and a larger size for rapid flow rates
-for elderly or smaller children you will need a smaller 22 or 24 gauge catheter

29
Q

Transfusion Reactions

A
  • Allergic
  • Bacterial
  • Febrile
  • Hemolytic Reactions
  • Circulatory Overload
30
Q

Transfusion Reactions: Allergic

A

allergy to blood being transfused

31
Q

Transfusion Reactions: Allergic: S+S

A

flushing, itching, wheezing, urticaria (hives); anaphylaxis if severe

32
Q

Transfusion Reactions: Allergic: Nursing Responsibilities

A
  • stop the transfusion
  • replace with a saline infusion
  • notify the provider immediately
  • administer prescribed antihistamine
33
Q

Transfusion Reactions: Bacterial

A

contamination of the blood

34
Q

Transfusion Reaction: Bacterial: S+S

A

fever, chills, vomiting, diarrhea, hypertension

35
Q

Transfusion Reaction: Bacterial: Nursing Responsibilities

A
  • stop the transfusion reaction
  • replace with a saline infusion
  • notify the provider
  • administer antibiotics as ordered
  • treat symptoms
36
Q

Transfusion Reactions: Febrile

A

temperature elevation due to sensitivity to WBC, plasma proteins, or platelets

37
Q

Transfusion Reactions: Febrile: S+S

A

fever, chills, warm, flushed skin, aches

38
Q

Transfusion Reaction: Febrile: Nursing Responsibilities

A
  • stop the transfusion
  • replace with saline infusion
  • notify provider
  • treat symptoms
39
Q

Transfusion Reaction: Hemolytic Reactions

A

destruction of RBCs as a result of infusing incompatible blood; occurs in 1 in 600,000 transfusions

40
Q

Transfusion Reactions: Hemolytic Reactions: S+S

A

fever, chills, dyspnea, chest pain, tachycardia, hypotension; can be fatal

41
Q

Transfusion Reactions: Hemolytic Reactions: Nursing responsibilities

A
  • stop transfusion immediately
  • replace with saline infusion
  • notify provider immediately
  • send remaining blood, including tubing and filter; a sample of venous blood, and the first voided urine to the lab for analysis
  • treat shock
42
Q

Transfusion Reactions: Circulatory Overload

A

administering too great a volume or too rapidly

43
Q

Transfusion Reactions: Circulatory Overload: S+S

A

persistent cough, crackles, hypertension, distended neck veins

44
Q

Transfusion Reactions: Circulatory Overload: Nursing Responsibilities

A

-slow or stop the transfusion
-monitor vital signs
-place client upright
-notify the provider
(do not replace with saline infusion because they are in fluid overload)

Nursing 172 (120 decks)

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