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Med Surg I > Wk 2 Blood Component Therapy: Nursing Implications > Flashcards

Wk 2 Blood Component Therapy: Nursing Implications Flashcards

1
Q

What are four different types of blood products?

A

Packed red blood cells (PRBCs)
Platelets
Fresh frozen plasma
Albumin

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2
Q

What are packed red blood cells?

A

Doesn’t have plasma, wbcs, or platelets

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3
Q

When a patient needs, PRBCs, what will the provider order?

A

Type and cross match

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4
Q

What is a type & cross match?

A

Determines person’s blood type

Determines compatibility between blood specimens, making sure no hemolysis takes place

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5
Q

What is a cross match called?

A

Indirect Coombs test

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6
Q

What type of reaction happens if someone receives a wrong blood type transfusion?

A

Hemolytic

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7
Q

What blood type is the universal donor?

A

O-

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8
Q

What blood type is the universal recipient?

A

AB+

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9
Q

What labs do you need to assess pretransfusion?

A

H&H

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10
Q

For a Hgb <6, a blood transfusion is recommended…

A

except in exceptional circumstances

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11
Q

For a Hgb of 6-7, a blood transfusion is..

A

Likely to be indicated

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12
Q

For a Hgb 7-8, a blood transfusion is…

A

May be appropriate in patients undergoing orthopedic or CT surgery, and in those with stable CVD

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13
Q

For a Hgb 8-10, a blood transfusion is…

A

Not indicated unless symptomatic anemia, hemorrhaging, acute coronary ischemia, thrombocytopenia with high risk of bleeding

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14
Q

For a Hgb greater than 10, a blood transfusion is

A

Not indicated unless in exceptional circumstances

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15
Q

How often should a type & cross match be completed?

A

Every 48 hours

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16
Q

For a blood transfusion, what must a patient do?

A

Sign a consent form

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17
Q

What might be indicated before a blood transfusion?

A

Pre-medicate

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18
Q

About how much volume is given during a blood transfusion with PRBCs?

A

250-350mLs

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19
Q

What size of venous access is needed for a blood transfusion?

A

20 g or larger, 18 g preferred

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20
Q

What type of tubing do you need for a blood transfusion and why?

A

Y tubing with a filter, one port for blood and one for NS

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21
Q

What type of solution can be used with PRBCs?

A

NS ONLY, can’t use D5 or LR because it will cause hemolysis of the cells

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22
Q

Can you hang LR and blood?

A

NO

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23
Q

Can you hang D5 and blood?

A

NO

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24
Q

How much time do you have to get the blood transfusion started once it arrives on the floor?

A

30 minutes, so be ready with supplies before it arrives

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25
Q

If you can’t start a blood transfusion within 30 minutes of it arriving, what is the best next nursing action?

A

Return the blood to the blood bank

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26
Q

What is infused first during a blood transfusion?

A

The blood bag is hung lower and completely transfused first, and then run the bag of normal saline to make sure all of the blood goes into the patient

27
Q

The final identity check of the patient should be done at the bedside with…

A

Two RNs

28
Q

How long does the nurse stay with the patient when they are receiving a blood transfusion?

A

15-30 mins

29
Q

What are s/s to lookout for during the initial start of a blood transfusion?

A

Chills
SOB
Itching
Back pain

30
Q

The nurse should take baseline…

A

VS before and after 15 mins

31
Q

How slow should you being a blood transfusion for first 15 mins?

A

1-2 ml/min

60-120 ml/hr

32
Q

Unless contraindicated, blood transfusions should be given in what amount of time?

A

2 hrs

33
Q

How often should you take VS during a blood transfusion?

A

Start, after 15 mins, every hour, and at the end

34
Q

What is the maximum amount of time for a blood transfusion and why?

A

4 hours because of risk for bacterial proliferation

35
Q

If you don’t get all of the blood in within 4 hours, what should you do?

A

Take the rest of the blood down and notify the HCP that you didn’t get it all in

36
Q

If patient is at risk for fluid volume excess, what might the provider order in-between infusions?

A

Diuretic (furosemide/lasix)

37
Q

Platelets are prepared from…

A

Fresh whole blood

38
Q

What volume are platelets?

A

30-60 mls (very small)

39
Q

How many platelet units can be obtained from one donor?

A

multiple

40
Q

How should platelet units be kept?

A

At room temperature

41
Q

How long are platelet units good for?

A

1-5 days

42
Q

How do you prevent clumping in the platelet bag?

A

Agitate the bag periodically

43
Q

How fast can platelets be administered?

A

As fast as they can be tolerated

44
Q

Does blood compatibility matter with platelets?

A

No

45
Q

What are the indications for platelet transfusion?

A

Platelet count below 20,000

46
Q

Platelets are not the same thing as…

A

Clotting factors

47
Q

Where are clotting factors found?

A

Plasma

48
Q

What is fresh frozen plasma?

A

Liquid portion of the blood separated and frozen

49
Q

What is the volume of fresh frozen plasma?

A

About 250 pls

50
Q

Does fresh frozen plasma contain platelets?

A

No

51
Q

Who will receive fresh frozen plasma?

A

Liver issues
Hemophilia
Von Willebrand’s

52
Q

Is blood compatibility required for fresh frozen plasma?

A

Yes

53
Q

How long is fresh frozen plasma good for?

A

Up to a year

54
Q

After thawing, how soon must fresh frozen plasma be used?

A

Within 24 hrs

55
Q

What are the indications for fresh frozen plasma?

A

Bleeding cause by deficiency is clotting factors

Fluid volume expander

56
Q

Albumin is a __ and has __ power

A

colloid, pulling

57
Q

What does albumin do?

A

Keeps fluid inside the intervascular space

58
Q

What is a normal albumin?

A

3.5-5

59
Q

Who might be low on albumin?

A 
Malnourished
Liver disease (can't make albumin)
60
Q

Albumin is prepared from…

A

plasma

61
Q

What percent albumin is oncotically equivalent/isotonic?

A

5%

62
Q

What percent albumin is oncotically hypertonic?

A

25%

63
Q

Is blood compatibility important for albumin?

A

No

Med Surg I (41 decks)

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