Blood and Blood Products

Question 1

Dx requiring whole blood transfusion

Answer 1

excessive blood loss: Hgb 6-10 g/dL; depends on findings​

Question 2

Dx requiring FFP

Answer 2

coagulation factor deficiency such as hemophilia

Question 3

Dx requiring PRBC transfusion

Answer 3

• anemia: Hgb 6-10 g/dL; depends on findings
• kidney failure

Question 4

Dx requiring platelet transfusion

Answer 4

thrombocytopenia/platelet dysfunction: Plt < 20,000, < 80,000 if active bleed

Question 5

A blood type

Answer 5

• contains A antigen
• antibodies against B
• receives A, O

Question 6

B blood type

Answer 6

• contains B antigen
• antibodies against A
• receives B, O

Question 7

AB blood type

Answer 7

• contains AB antigen
• no antibodies
• receives A, B, AB, O

Question 8

O blood type

Answer 8

• no antigens
• antibodies against A, B
• receives O

Question 9

transfusion types

Answer 9

• homologous
• autologous
• intraoperative blood salvage

Question 10

homologous transfusion

Answer 10

blood from donors

Question 11

autologous

Answer 11

patient’s own blood

Question 12

intraoperative blood salvage

Answer 12

• blood lost in certain surgeries recycled through cell-saver machine, transfused intra- or postoperatively
• orthopedic surgery
• CABG

Question 13

blood components

Answer 13

• albumin
• clotting factors
• cryoprecipitate
• packed RBCs
• plasma
• platelets
• prothrombin complex

Question 14

transfusion rxns

Answer 14

• acute hemolytic
• febrile
• mild allergic
• anaphylactic

Question 15

acute hemolytic rxn

Answer 15

• onset: immediate
• s/sx
  
  • chills
  • fever
  • low back pain
  • tachycardia
  • flushing
  • hypotension
  • chest tightening
  • pain
  • tachypnea
  • nausea
  • anxiety
  • hemoglobinuria
  • CV collapse
  • renal failure
  • DIC
  • shock
  • death

Question 16

febrile rxn

Answer 16

• onset: 30 min to 6 hr
• s/sx
  
  • chills
  • fever
  • flushing
  • headache
  • anxiety
• interventions
  
  • use WBC filter
  • give antipyretic

Question 17

mild allergic rxn

Answer 17

• onset: during transfusion or up to 24 hr
• s/sx
  
  • itching
  • urticaria (hives)
  • flushing
• intervention: antihistamine such as diphenhydramine

Question 18

anaphylactic rxn

Answer 18

• onset: immediate
• s/sx
  
  • wheezing
  • dyspnea
  • chest tightness
  • cyanosis
  • hypotension
• interventions
  
  • maintain airway
  • O₂
  • IV fluids
  • antihistamine
  • corticosteroid
  • vasopressor

Question 19

blood/blood product transfusion complications

Answer 19

• circulatory overload
• sepsis and septic shock

Question 20

circulatory overload risk factor

Answer 20

impaired cardiac fxn

Question 21

circulatory overload s/sx

Answer 21

• dyspnea
• chest tightness
• tachycardia
• tachypnea
• headache
• HTN
• JVD
• peripheral edema
• orthopnea
• sudden anxiety
• crackles in lung bases

Question 22

circulatory overload interventions

Answer 22

• O2
• monitor VS
• slow infuction rate
• give diuretics as prescribed
• notify provider immediately

Question 23

sepsis/septic shock s/sx

Answer 23

• fever
• nausea
• vomiting
• abd pain
• chills
• hypotension

Question 24

sepsis/septic shock interventions

Answer 24

• maintain patent airway
• O2
• samples for blood cultures
• antibiotics as prescribed
• vasopressors (i.e. dopamine) in late phase
• elevate feet