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NSG 356 - Clinical Applications & Reasoning II > [M2] Blood Administration > Flashcards

[M2] Blood Administration Flashcards

(73 cards)

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1
Q

When might a patient need a blood transfusion?

A
  • severe anemia
  • abnormal/active blood loss
  • trauma
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2
Q

What is whole blood made of?

A
  • erythrocytes
  • platelets
  • leukocytes
  • water
  • plasma
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3
Q

What percent of whole blood is plasma?

A

55%

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4
Q

45% of whole blood is made of what?

A

formed erythrocytes

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5
Q

When would a patient require whole blood?

A

following trauma or upon surgery

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6
Q

When would a patient require packed red blood cells?

A

trauma, surgery, anemia, blood disorders, or any blood loss

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7
Q

When would a patient require platelets?

A

cancer treatments, surgery/organ transplants, liver disorders

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8
Q

When would a patient require plasma?

A

burns, shock, bleeding disorders

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9
Q

What are the 8 steps for Pre-Transfusion prep?

A
  1. validate order
  2. validate informed consent
  3. assess IV site/size and patency
  4. gather blood tubing
  5. prep equipment
  6. obtain a complete set of vitals
  7. patient assessment
  8. patient education
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10
Q

When do you call the blood bank?

A

after gathering supplies and once everything is set up

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11
Q

How much time do you have to give the transfusion once you’ve left the blood bank?

A

30 minutes

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12
Q

What needs to be checked before a blood transfusion? By who?

A
  • compare label on bag itself and order on-screen
  • check the bag has the correct blood type, unit number, and expiration date
  • ensure units match, expirations match, and blood types are compatible

done by 1 RN and 1 MD/RN/LPN

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13
Q

What rate do you start an infusion?

A

slow; increase after 15 minutes

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14
Q

The nurse must stay with the patient for how long once the transfusion has started? Why?

A

15 minutes

to ensure no reactions/patient is tolerating

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15
Q

What is the nurse responsible for once a transfusion has started?

A
  • stay with the patient for 15 minutes
  • do not give other fluids or medications
  • take vitals at the 15 minute mark
  • review signs and symptoms of reactions with the patient
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16
Q

What should be done before leaving a patient with a transfusion?

A

review signs and symptoms of transfusion reactions

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17
Q

How long does a transfusion last?

A

4 hours

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18
Q

What should be done after a transfusion?

A
  • complete vitals
  • proper equipment disposal
  • assess the patient
  • pre–medications between units (if multiple)
  • post–transfusion lab study to complete
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19
Q

What is TRALI?

A

transfusion related acute lung injury; rare, potentially fatal

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20
Q

What are the signs of TRALI?

A
  • respiratory distress
  • tachypnea
  • hypoxemia
  • hypotension
  • fever
  • NONcardiogenic pulmonary edema
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21
Q

What is the onset time of TRALI?

A

within 6 hours of the transfusion

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22
Q

What is TACO? What causes it?

A

transfusion associated circulatory overload

caused by large volume of transfusion over a short period of time, or in those with underlying CV or renal disease

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23
Q

What are the signs of TACO?

A
  • respiratory distress
  • tachypnea
  • hypoxia
  • hypertension
  • cardiogenic pulmonary edema
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24
Q

What is the onset time of TACO?

A

longer than 6 hours following a transfusion

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25
What is the **FIRST** priority if a transfusion reaction is suspected?
STOP THE TRANSFUSION IMMEDIATELY
26
What should be done after a transfusion is stopped due to suspected transfusion reaction?
- obtain vitals - assess for changes - notify provider - treat symptoms - monitor patient
27
What are some alternatives to transfusions?
- PO iron supplementation for anemia - IV iron - erythropoietin (EPOGEN)
28
What is **EPOGEN**? What does it do?
blood transfusion alternative increases RBC production
29
What does the suffix "*-penia*" mean in phlebotomy/labs?
lack or deficiency
30
What does the suffix "*-osis*" mean in phlebotomy/labs?
increase
31
What is a **CBC**? What labs are included in it?
complete blood count; evaluates cells that circulate in the blood RBCs, WBCs, and platelets
32
What is a **CBC w/diff**?
measures the number of each type of WBCs
33
Why might a CBC w/Diff be ordered instead of a baseline CBC?
CBC w/Diff is used to monitor different conditions and help diagnosis
34
What is a **hematocrit** level?
percentage of red blood cells in your blood
35
What is a **hemoglobin** level?
number of red blood cells with O2 carrying capacity
36
What are **segs/bands**?
first line of defense against infection
37
What are **lymphocytes**?
natural killer cells (T and B cells)
38
What are **monocytes**?
level indicates presence of chronic infection, autoimmune, or blood disorders
39
What are **eosinophils**?
level indicates presence of parasitic infection, allergic reaction, or cancer
40
What are **basophils**?
indicates fungal or bacterial infection
41
What labs are collected from a **light blue** tube? What does it contain?
coagulation studies (PT/INR, aPTT, etc.) sodium citrate as an anticoagulant
42
What lab should be monitored if your patient is on Heparin?
aPTT
43
What lab should be monitored if your patient is on Warfarin?
PT/INR
44
What is the evaluation of **aPTT** for?
- monitoring (not initiation) of Heparin - assessment of clotting factor function in hemophilia and von Willebrand disease
45
What is the evaluation of **PT/INR** for?
- monitoring of Warfarin - evaluation of vitamin K deficiency or severe malnutrition - assessment of liver failure
46
What is the evaluation of **BOTH** PT/INR and aPTT for?
- active bleeding without cause - evidence/history of abnormal or excessive bleeding - suspected or confirmed DIC - high risk patients in whom a history is unavailable
47
What labs are collected from a **gold** tube? What does it contain?
chemistry, serology, and immunology tests a barrier and serum to decrease hemolysis (breakdown of RBCs)
48
What is the difference between a **BMP** and **CMP**?
basic vs. complete metabolic panel CMP includes all of BMP with additional tests
49
What two electrolyte panels need to be ordered separately?
magnesium and phosphorous
50
What does a BMP evaluate?
fluid levels and electrolytes
51
What labs are collected from a **green** tube? What does it contain?
cardiac, troponin and creatine kinase (CK) nothing
52
What is a **troponin** level?
primary biomarker for diagnosis of myocardial necrosis (heart damage)
53
What is a **creatine kinase** level?
an enzyme-cardiac marker used to assist diagnoses of acute MI
54
What labs are collected from a **purple** tube? What does it contain?
CBCs, ESRs, Hgb A1C, and BNP EDTA to block clotting cascade, stabilizing RBCs, WBCs, and platelets for 24 hours
55
What does an **ESR** level show?
indirectly measures level of certain proteins in blood; correlates with the amount of inflammation in the body
56
What does a **Hgb A1C** level show?
measures what percentage of hemoglobin is coated with sugar
57
What is a **BNP** level?
B-type natriuretic peptide; primarily used to diagnose heart failure
58
What labs are collected from a **pink** tube? What does it contain?
ONLY type and cross/screen EDTA to block clotting cascade
59
What can cause a LOW **neutrophil** level?
chemotherapy
60
What can cause a HIGH **neutrophil** level?
infection
61
What could a HIGH **Hct** level indicate?
dehydration or COPD
62
What could a LOW **Hct** level indicate?
anemia, hemorrhage, overhydration, cirrhosis, or kidney disease
63
What could a HIGH **Hgb** level indicate?
COPD, dehydration, burns
64
What could a LOW **Hgb** level indicate?
anemia, hemorrhage, kidney disease, cancer
65
What could a HIGH **Hgb A1C** level indicate?
diabetes/pre-diabetes
66
Which blood type is the universal recipient?
AB+
67
Which blood type is the universal donor?
O-
68
What can cause a LOW **lymphocyte** level?
lupus, late HIV
69
What can cause a HIGH **lymphocyte** level?
viral infection, leukemia
70
What can cause a LOW **monocyte** level?
bone marrow insufficiency
71
What can cause a HIGH **monocyte** level?
inflammation, some leukemias
72
What can cause a HIGH **eosinophil** level?
parasitic infection or allergic reaction
73
What can cause a HIGH **basophil** level?
allergic reaction (food), chronic inflammation

NSG 356 - Clinical Applications & Reasoning II (4 decks)

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