Flashcards in Blood Products & IV Fluids Deck (45):
Role of Blood in Oxygen Delivery
Blood delivers oxygen to tissues
Anemia impairs oxygen delivery
Oxygen delivery = cardiac output x arterial oxygen content
Risks of Transfusing Blood Products
Allergic and immune transfusion reaction
Patients who are More Sensitive to Volume Overload
Patients who are More Sensitive to Hyperkalemia
Patients who Develop Iron Overload
Large number of transfusions
Define Massive Transfusion
Replacement of blood volume in a 24 hour period OR 50%+ of blood volume in 4 hours
Pneumonic for the Complications of a Massive Transfusion
What does the pneumonic PATCH stand for in massive transfusions?
P: platelets decrease, potassium increases
A: ARDS, acidosis
T: temp decrease
C: citrate intoxication
H: hemolytic reaction
What does a type and screen determine?
ABO and Rh status and the presence of most commonly encountered antibodies
What does a type and crossmatch determine?
ABO and Rh status as well as adverse reaction to even low incidence antigens
Not be based on Hgb/Hct levels alone
Generally symptomatic and Hgb of 6-10 g/dL
What hemoglobin level do studies indicate to target when providing blood products?
By what factor does oxygen delivery exceed oxygen consumption?
Factor of 4
Compensatory Mechanisms for Delivery of Oxygen
Increased cardiac output
Rightward shift of the oxygen-hemoglobin dissociation curve
Increased oxygen extraction
Factors in the Decision to Transfuse Blood Products
How long after an infusion can you check the Hgb/Hct levels?
When would you use FFP?
When do you transfuse platelets?
Low platelet counts that are symptomatic
Which blood type is the universal donor?
Which blood type is the rarest?
Which blood types are the most common?
Solutions that contain small molecules and are able to pass through semipermeable membranes
Why are isotonic solutions given?
Expand the ECF
Why are hypotonic solutions given?
Why are hypertonic solutions given?
Increase ECF volume
Decrease cellular swelling
Solutions that contain high molecular weight proteins or starch
Where is the final location of colloids?
Too large to pass through the capillary walls
What type of fluid are D5W, D10W, and D50W?
What type of fluid is albumin?
What type of fluid is dextran?
What type of fluid is saline?
What type of fluid are D5 1/2, D5NS, and D10NS)?
What type of fluid is hexastarch?
What type of fluid is ringer's lactate (LR)?
Signs and Symptoms of Intravascular Depletion
Flat jugular veins
Signs and Symptoms of Interstitial Fluid Depletion
Decreased skin turgor
+/- hemodynamic effects
Final Location of 0.9% Saline
Final Location of 5% Albumin and PRBCs
Which electrolytes are lost in sweat and exhaled water vapor?
Which electrolytes are lost in the urine?
All of them
Which patients do not need maintenance sodium or potassium?
Renal failure patients
How is sodium regulated?
Renal water handling
Conditions that Cause Fluid Loss
Conditions that Cause Fluid Gain