Flashcards in Blood And Fluid Deck (61)
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1
One unit of PRBCs raises the Hct by _____ %?
3%
2
Identify the areas of the upper extremities that are at high risk for developing position related nerve damage?
Ulnar Neuropathy, Brachial Plexus, Radial and median nerve
3
Most common ocular injury?
Corneal Abrasion
4
main complication with the supine lithotomy position?
Airway Obstruction and decreased Tidal Volumes
5
In the supine position abdominal contents cause a decrease in the patients ________?
Functional Residual Capacity (FRC) by 25%
6
The ________ lies in close proximity to the fixed first rib, clavicle and humerus and is predisposed to compression.
Brachial plexus
7
The number one nerve injury related to positioning involve the _______?
Ulnar Nerve
8
The classic site of injury to the ulnar nerve is?
Behind the ulnar groove behind the medial epicondyle of the humerus
9
This position is associated with the greatest number of ocular injuries?
Lateral
10
When supine the arms should not be abducted greater than ______ degrees and the wrist should be _______?
90, supinated (palms up)
11
Trendelenberg postion affects the body in what manner?
Increase: CVP, ICP, Intraocular pressure
Decrease: FRC and Pulmonary compliance
12
4 ways to avoid a Brachial Plexus injury?
Keep Head Midline
Arms kept at < 90 degrees
Elbows mildly flexed
Use a non-sliding mattress for Trendelenburg
13
Reverse trendelenberg affects the body in what manner?
Decreases venous return
14
What is the biggest concern for a patient in the sitting position?
Air embolism
15
what is the best way to detect a air embolism?
Esophageal stethoscope
16
3 goals of positioning?
Maximum exposure for the surgeon
Access to the patient for ventilation and monitoring
Promote satisfactory surgical results
17
Greater then ______ hours for surgery increase position related injuries?
4-5 hours
18
_________ accounts for 89% of all postop visual loss?
Ischemic optic neuropathy (ION)
19
1 Unit of PRBCs raises the Hgb _______ ?
1 gm
20
FFP is viable for _____ and has a volume of ______ ?
1 yr, 200-250 ml
21
1 unit of Platelets increase the count by____?
5,000 - 10,000
22
For every 4 units of PRBCs give ________?
1 unit of FFP
23
For every 8 units of PRBCs give ______, _______?
2 units of FFP, 4 pack of Platelets
24
Autologous blood can be obtained by ____, ____, _____?
Predepositing, Hemodilution (removing 1-2 units immediately intraoperatively), Post-op Salvage
25
_____ is the % of red cells to the total volume of blood?
HCT
26
TRALI stands for?
Transfusion Related Acute Lung Injury
27
In an anesthetized Pt with a NMBA on board. The most likely signs we will see of a transfusion reaction are ____, ____, ____?
Free Hgb in the Urine, increase in airway peak pressures and elevation in temp
28
________ is the second most common transfusion reaction?
Transfusion Related Acute Lung Injury (TRALI)
29
Albumin 5% replaces volume in a ___ to ___ ratio?
1 to 1
30
Albumin 25% expands volume by _____ and within _____ minutes?
2.5 - 5 times and within 15 minutes
31
Most common reason for coagulopathies are?
Lack of functioning Platelets
32
What is considered an acceptable urinary output?
0.5ml/kg/hr
33
What is the formula for calculating maintenance fluid?
4 ml/kg/hr for the first 10kg
For the next 10-20 kg add 2 ml/kg/hr
for each kg above 20 add an additional 1 ml/kg/hr
34
Most common transfusion reaction is?
Febrile
35
Types of transfusion reactions are?
Febrile, Allergic, Hemolytic
36
what genetic disease benifits from the administration of cryoprecipitate?
Hemophilia A ( factor VIII deficient)
37
What is the Hct of 1 unit of PRBCs?
70% Hct 250 ml's
38
Calculate the allowable blood loss if the Hct is 40 and allowable blood loss to a Hct of 30 in a 80 kg male Pt.
Estimated Blood volume: 75ml x 80kg= 6000ml.
RBCV40%= 6000x0.4=2400
RBCV30%= 6000x0.3=1800
2400-1800=400ml
allowable blood loss =3x400=1200 ml
39
Average blood volume per kg for female is?
65 ml/kg
40
Average blood volume per kg for male is?
70-75 ml/kg
41
Intraoperative fluid replacement for insensible loss is?
2 ml/kg
42
Intraoperative fluid replacement for minimal surgical trauma is?
2-4 ml/kg
43
Intraoperative fluid replacement for severe surgical trauma is?
6-8 ml/kg
44
Intraoperative fluid replacement for moderate surgical trauma is?
4-6 ml/kg
45
For every 1 ml blood loss replace it with ____ ml of crystalloid?
3 ml
46
Treatment of Hyperkalemia could entail?
Hyperventilation, IV Calcium, or D50 Insulin and bicarb
47
Citrate in PRBC units contribute to _____ and _____?
Metabolic Alkalosis and Hypocalcemia
48
Blood stored accumulates ___, ___ and decreases in ____?
H+ ions, K+ and decreases in 2,3 DPG
49
1 liter of LR contains what electrolytes and how much?
Na 130mEq, Cl 109mEq, K 4mEq, Ca 3 mEq, Lactate 28 mEq
50
1 liter of Normal Saline contains what electrolytes and how much
Na 154 mEq and Cl 154 Meq
51
Advanced Trauma Life Support (ATLS) Classification 1 R/T Blood loss?
750 ml or less, HR <100, BP normal, RR normal, Blanch ok, UOP normal, Anxious
Replace with crystalloid.
52
Advanced Trauma Life Support (ATLS) Classification 2 R/T Blood loss?
750-1500 ml, HR >100, BP normal, RR 20-30, Blanch + , UOP 20-30, Anxious
Replace with crystalloid
53
Advanced Trauma Life Support (ATLS) Classification 3 R/T Blood loss?
1500-2000 ml, HR >120, BP decreased, Blanch + , UOP 5-15, Anxious and confused
Replace with crystalloid and blood
54
Advanced Trauma Life Support (ATLS) Classification 4 R/T Blood loss?
> 2000 ml, HR >140, BP decreased, RR >35, Blanch + , No UOP, Anxious and confused and lethargic
GIVE BLOOD and crystalloid
55
A soaked 4x4 is equal to ____ ml?
10 ml
56
A soaked Lap pad is equal to ____ ml?
100-150 ml
57
Platelets are usually given when the count is less then _______?
50,000
58
Crystalloid intravascular half-life is?
20-30 min
59
Colloid intravascular half-life is between ____?
3-6 hrs
60
NPO deficit is given how much the first, second, and third hour?
1st hour give 1/2 the total NPO deficit
2nd hour give 1/4 the total NPO deficit
3rd hour give 1/4 the total NPO deficit
61
