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NCLEX!!! > Blood and IV therapy > Flashcards

Blood and IV therapy Flashcards

1
Q

packed RBCs given for

A

surgery pts or anemic

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2
Q

platelets given to

A

cancer pts

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3
Q

plasma given to

A

burn pts

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4
Q

albumin is

A

a volume expander

therefore can cause circulatory overload

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5
Q

prothrombin given to

A

increase clotting time

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6
Q

factor VIII given for

A

hemophilia

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7
Q

universal donor

A

O

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8
Q

universal recipient

A

AB

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9
Q

only IV fluid that can be used with blood

A

normal saline (0.9% NaCl)

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10
Q

If transfusion reaction occurs with blood then

A
  1. Stop the infusion
  2. restart NS
  3. Save blood containers and tubing to return to lab
  4. draw blood sample for plasma, hemoglobin, culture, retyping
  5. collect urine sample for hemoglobin
  6. monitor voiding for hematuria

check airway,
can give antihistamines, Benadryl, steroids, and aspirin

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11
Q

autologous transfusion

A

give blood to yourself
collected 4-6 weeks before surgery
iron supplements may be ordered

benefits - prevention of infection from donated blood, used for pts with hx of reaction, rare blood types

contraindications - acute infection, chronic disease, hemoglobin

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12
Q

Allergic reaction to blood

A

hypersensitivity to antibodies in blood
occurs immediately or within 24 hours
mild - urticaria, itching, flushing
anaphylaxis - hypotension, dyspnea, decrease O2 sat, flushing

can prevent by premedication with antihistamines

stop blood
restart NS
notify MD
Benadryl, oxygen, corticosteriods

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13
Q

hemolytic reaction to blood

A 
incompatibility 
occurs within mins - 24 hrs
 nausea, vomiting, pain in lower back, hypotension, increased pulse, decrease in urinary output, hematuria
stop blood
oxygen, benadryl, airway management
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14
Q

Febrile nonhemolytic reaction to blood

A

most common, antibodies to donor platelets or leukocytes
fever, hills, nausea, headache, flushing, tachycardia, palpitations
stop blood
antipyretics (avoid aspirin if pt thrombocytopenic)
seen after multiple transfers

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15
Q

sepsis related to blood transfusion

A 
tachycardia, hypotension, high fever, chills, shock
stop blood
obtain blood culture
antibiotics 
IV fluids
vasopressors
steroids
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16
Q

circulatory overload from blood

A

dyspnea, crackles, increased respiratory rate, tachycardia
slow/discontinue transfusion

high risk - elderly, heart disease, transfusion

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17
Q

primary purpose of IV therapy

A

to maintain or restore fluid and electrolyte balance

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18
Q

isotonic fluids

A

same concentration as body fluids so no shifting of fluids

19
Q

hypertonic fluids

A

solute concentration greater than body fluids

pull fluids into the vessels

20
Q

hypotonic fluids

A

solute concentration less than that of body fluids

pull fluids into the tissues

21
Q

0.45% NaCl

A

hypotonic

22
Q

0.9% NaCl

A

isotonic

23
Q

10-15% dextrose in water

A

hypertonic

24
Q

3% NaCl

A

hypertonic

25
Q

lactated ringer’s

A

isotonic

26
Q

sodium bicarbonate 5%

A

hypertonic

27
Q

5% dextrose in water

A

isotonic but becomes hypotonic when glucose metabolized

28
Q

ml per hr

A

total solution/hours to run

29
Q

drops per min

A

total volume x drop factor / time in mins

30
Q

change tubing every

A

72 hours

31
Q

change bags every

A

24 hours

32
Q

circulatory overload

A

assessment:
crackles, dyspnea, confusion, seizures

nursing care:
reduce IV rate, assess VS, assess lab values, notify MD

33
Q

infiltration

A

assessment:
edema, pain, coolness in area, significant decrease in flow rate, apply tourniquet above infusion site and if continues to drip then infiltrated

nursing care:
discontinue IV, apply warm compress, sterile dressing, elevate arm, start new IV proximal

34
Q

extravasation

A

infiltration of vesicant

vesicant - medication that causes blisters and tissue sloughy
gentamycin penicillin, vanco, dilantin, antinepletics, calcium, potassium, epi

pain, burning, edema, blanching at site

tx: prevention - place meds in larger vein
stop IV, aspirate then notify MD

35
Q

vesicants

A

gentamycin penicillin, vanco, dilantin, antinepletics, calcium, potassium, epi

36
Q

phlebitis

A

irritation
assess:
reddened, warm area around insertion site, tenderness, swelling

nursing care:
discontinue IV, warm/moist compress, restart new IV

37
Q

thrombophlebitis

A

irritation
assess:
pain, swelling, redness and warmth around insertion or along path of vein, fever, leukocytosis

nursing care:
discontinue IV, apply warm compress, elevate extremity, restart IV in opposite extremity

38
Q

hematoma

A

assess:
ecchymosis, immediate swelling at site, leakage of blood at site

nursing care:
discontinue IV, apply pressure with sterile dressing, cool compress for 24 hrs followed by warm compress, restart iv in opposite extremity

39
Q

clotting

A

assessment:
decreased IV flow rate, back flow of blood into IV tubing

nursing care:
dc IV, do NOT irrigate or milk tubing, do NOT increase IV flow rate or hang solution higher, do NOT aspirate clot form cannula, urokinase may be injected to clear occlusion

40
Q

PICC complications

A

malposition, pneumothorax, dysrythmias, nerve or tendon damage, respiratory distress, catheter embolism, thrombophlebitis

41
Q

PICC nursing care

A

change dressing 2-3 times a week
flush with NS alone or with NS followed by heparinized saline
do not take bp or draw blood on extremity

42
Q

tunneled central catheter

A

hickman, groshong, permacath
long term
increases in size
complications - thrombosis, phlebitis, air embolism, infection, bleeding, vascular perforation

43
Q

triple lumen central catheter

A

distal lumen - draw blood
middle lumen - TPN
proximal - infuse blood and admin meds

NCLEX!!! (7 decks)

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