Ch 27 blood products Flashcards

0
Q

What exactly does blood products include

A
Packed RBC
Platelets
Plasma
White blood cells 
Albumin
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1
Q

What are blood products

A

They are used to increase intravascular volume, replace clotting factors, and components of blood, replace blood loss, and improve oxygen carrying capacity.

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2
Q

What does the blood product WBC do

A

It increases circulating blood volume
It is replacement therapy for acute blood loss secondary to traumatic injuries or surgical procedures
It is volume expansion in clients who have extensive burn injury, dehydration, and shock

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3
Q

What does the blood product PACKED RBCS do

A

It increases the number of RBCS
It is for severe symptomatic anemia HBG 6-10
It is for hemoglobinopathies
M
It is for medication induced hemolytic anemia
It is for erythroblastosis fetalis

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4
Q

What is the blood product platelet concentration use for

A

It increases platelet count
It is indicated for thrombocytopenia ( platelet counts less than 20,000)
Aplastic anemia
Chemotherapy induced bone marrow suppression
It is indicated for active bleeding ( platelet count less,than 50,000)

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5
Q

What is fresh frozen plasma

A

It replaces coagulation factors

It is indicated for active bleeding or massive HEMMORRHAGE
Extensive burns, shock, disseminated intravascular coagulation DIC
Antithrombin 3 deficiency
Reversal of anti coagulation effects of warfarin

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6
Q

What pheresed granulocytes

A

Replaces neutrophils/ granulocytes

It is indicated for severe neutropenia ( ANC less,than 500)
Life threatening bacterial/ fungal infection not responding to antibiotic therapy
Neonatal sepsis
Neutrophil dysfunction

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7
Q

What is the blood product albumin indicated for

A

It expands circulating blood volume by excreting oncotic pressure

It is used for hypovolemia 
Hypoalbuminemia
Burns
Adult respiratory distress
Cardiopulmonary bypass surgery
Hemolytic disease of the newborn
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8
Q

What type of reaction are you at risk for when administered the blood product albumin

A

Risk for fluid volume excess such as pulmonary edema

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9
Q

For a client at risk for fluid overload or older adults, what is a nursing administration in regards to blood products

A

Transfuse a unit of PRBC over 2-4 hr, avoiding any concurrent infusion infusing. Monitor vitals q15 min. If possible wait 2 hr between units of blood when multiple units have been prescribed
Place client upright with feet down
Administer diuretic and oxygen as appropriate
Monitor I &O
Prior to any transmission, assess kidney, respiratory, and cardiovascular function for risk of overload

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10
Q

When administering blood products if sepsis occurs what should you do

A

Notify provider
Obtain Blood culture send transfusion bag for analysis for possible contaminants and treat sepsis with antibiotics, IV fluids, vasopressors, and steroids

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11
Q

What guage catheter should you use when administering blood products

A

Ensure that a 20 guage or,larger is used to avoid hemolysis of blood cells.

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12
Q

What is the only fluid that can be used when using blood products

A

0.9% sodium chloride
Prime IV and tubing with this solution.
Use a blood filter for most blood products and either a Y type or straight tubing set.

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13
Q

How long should whole blood, red blood cells be administered

A

About 250ml/ unit; infuse within 2-4 hr

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14
Q

Platelet concentration

A

About 300 ml / unit ; infuse PRBC within 15-30 min/unit

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15
Q

Fresh frozen plasma should be administered how long

A

About 200ml/unit ; infuse within 30-60 min/unit

16
Q

How long should albumin be administered

A

5%, 250 to 500 ml bottle infuse 1-10 ml/min

25% 50-100 ml bottle infuse 4 ml/min

17
Q

For administration of a massive transfusion, what should the nurse keep in mind

A

Monitor platelet, PT, aPTT every 5 units and replace as needed
Monitor potassium and calcium levels
Monitor ECG for changes associated with hypokalemia, hyperkalemia, or hypocalcemia
Warm blood using a blood warmer to prevent hypothermia

18
Q

How long should an infusion of 300ml of platelet concentration run

A

Within 15-30 min/ unit because platelets are fragile and should be administered quickly to reduce the risk of clumping

19
Q

How long should fresh frozen plasma be administered

A

Within 30-60 min/ unit

20
Q

How long should a unit of whole blood or PRBC be administered

A

Within 2-4 hours

21
Q

What should be administered for aPTT 1.5 times the usual range

A

Fresh frozen plasma replaces coagulation factors and can help prevent bleeding