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Test 2 > Paternal Fluids and Blood products > Flashcards

Paternal Fluids and Blood products Flashcards

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1
Q

what are crystalloids

A

small molecules that

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2
Q

cystalloids

A

that flow from vascular to interstitial

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3
Q

________solution has the same osmolality as plasma

A

isotonic solution

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4
Q

what is the osmolality of an isotonic solution

A

280-300

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5
Q

In an isotonic solution fluid mainly stays in the

A

ECF

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6
Q

Name Isotonic solutions

A

NS=NaCl .9%=free water and no calories

Lr(Na, Cl, K, Ca, lactated ringers)

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7
Q

A ______solution has a lower osmolality than normal plasma.

Water is pulled from ________to _________.

A

hypotonic solution=lower osmolality

moves from vessels to cells

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8
Q

A type of hypotonic solution is

A

1/2 NS=.45% NaCl

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9
Q

Describe a fluid shift in an hypertonic solution

A

fluid shifts from intracellular to extracellular

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10
Q

Colloids are _____molecular weight made of ____and _____.
They remain in the _______space.
They pull fluid from _______ and ___________ space.
They are known as ___________.
Types include:

A

Colloids are ___high__molecular weight made of starch and proteins.
They remain in the intravascular space.
They pull fluid from intracellular and interstitial space.
They are known as volume expanders.
Types include: Albumin, Dextrose, Hespan, Plasma protein factors

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11
Q

What are some benefits of using albumin?

A 
Derived from plasma
heat treated
No ABO antibodies
no transfusion reaction risk
no Hep or HIV transmission
remains in vascular longer
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12
Q

What is something that must be watched when using albumin?

A

it stays in the vascular longer so you must watch for fluid volume overload

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13
Q

Describe Albumin 5%

A
  • 5 gm/100 ml
  • isotonic solution
  • maintains COP
  • used for rapid volume expansion
  • give 2-4 ml/min
  • comes in 250-500ml
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14
Q

Descrive Albumin 25%

A
  • hypertonic
  • expands volume 4-5 times the volume infused
  • shift from interstitum to intravascular
  • give 1 ml-minte to prevent rapid shift
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15
Q

Albumin 25% is commonly used for

A

burn patients

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16
Q

Indications of using albumin

A

volume expanders-> surgery, burns, and trauma
volume expander->patient who is waiting for T & C for blood
blood pressure support

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17
Q

Albumin is contraindicated in these patients

A

in anemic patients-may dilute more

dehydration-pulling fluid from cells further dilutes us

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18
Q

Antigens in Blood

A

ABO blood group
Rh factor
Human Leukocyte antigen

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19
Q

what is a type and screen

what is a type and Cross

A

type and screen is when general antibody info is needed

type and cross is when pts blood is crossed w/ someone else’s and try to match as many antibodies as possible

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20
Q

People with type A blood have
antibodies-
donate to-
receive from-

A

anti B antibodies
give to A and AB
receive from A and O

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21
Q

People with type B blood have
antibodies-
donate to-
receive from-

A

antibodies: Anti A
give to B and AB
recieve from B and O

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22
Q

People with type AB blood have
antibodies-
donate to-
receive from-

A

antibodies-none
give to no one
receive from A,B,AB, and O

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23
Q

Rhesus Antigen Rh antibody in______.
1st exposure
2nd exposure

A

RBC
1st exposure-sensitizes
2nd- exposure is possible fatal

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24
Q

Human Lekocyte antigen are on _________

responsible for________during_______

A

platletes, WBC, and tissue cells

febrile reaction during transfusions-causes platlette destruction

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25
what kind of people will benefit from HLA testing
people who receive many transfusions over time | those who receive transfusions over a short period of time
26
Whole Blood contains
RBC, platelettes, and plasma
27
when is whole blood used
used for massive hemmorage where more than 25% of the blood volume has been lost
28
Whole Blood comes in _____units
500 ml units
29
when giving whole blood you can expect Hg to go up ____ and HCT up to _____
Hg by 1 gm | and HCT by 3-4%
30
Packed Red Blood Cells are formed by taking____ml of ____ same _____count as whole blood _____viscosity-use______to dilute
250 ml of plasma same RBC count as whole blood High viscosity use NS dilute
31
why would we use PRBC
TO IMPROVE OXYGEN CARRYING CAPACITY IMPROVE COLLOIDAL ONCOTC PRESSURE STILL IRON IN THIS
32
what is leukocyte depleted blood
leukocytes removed by filtration
33
why would we use leukocyte depleted blood
on patients that have a history of febrile transfusions immunocompropised multiple transfusions over time
34
how are platlettes given? Random donor Vs. Single donor uses
platelettes are given in 30-50 ml/unit--IV bolus with a special filter random donor comes from 6-10 people -increase plt count by 10,000--> increased risk of allergic reaction single donor-increase platless by 60,000-->less risk of allergic reaction
35
why would someone need a platlett transfusion?
Control bleeding DIC Thrombocytopenia-unless it is ideopathic in this case platelet transfusion will not do any good-tear up platelets
36
Fresh frozen plasma contains must be______ uses__-_______
clotting factors, fibrinogn--NO PLATELETS must be thawed uses for clottingfactors IC, hemmorage, liver disease, reverse coumadin effects
37
i someone is getting FFP we need to wath for
fluid overload | Hypocalcemia-the citric acid that preserves blood binds with CA
38
cryoprecipitate contains factors can give______ @______ used for
factors VIII Factor XIII, and fibrinogen 6-10 units can give rapidly10 ml/min used for: hemophilia A, DIC, Von Willie Brands Disease
39
wht kind of iv must be used to hang blood
18-20 gauge=large so blood w/ not be damaged central line is preffered
40
blood can only be administered with
NS | do not mix anything else
41
Blood must be identified by
2 licensed nurses
42
after giving blood nurse must stay with patient for
15 minutes
43
blood must be given with ____ time from getting on the unit
30 minutes
44
blood is to be given at a rate of | exception:
1 unit over 2 hours exception is for trauma patients
45
change tubing on blood q
every 4 hours or 2 units
46
blood can not hang more than
4 hours
47
what is the first action if reaction is suspected
stop the infusion ******
48
Transfusion reaction
``` stop call dr keep iv NS, replace tubing give blood tubing to lab investigation reports ```
49
what is endogenous
-my body does not like it causes:antigen-antibody reactions allergic bacterial contamination plasma protein incomptibility febrile hemolytic iiiii
50
Alergic Reaction==> CAUSE, Symptoms, Treatment
causes from allergen from blood | symptoms aare-AFN-anaphylaxis, fever, nausea/vomit
51
Endogonous-bactrial contamination caues symptoms treatment
cause is organism survives the cold Pseudo and Staph Symptoms: abdominal cramps, fever, chills, nausea, diarrhea, shock Treatment: stop dr, antibiotics, epi, corticosteroids
52
febrile reaction from ________ causes symptoms treatment
reaction to leukocytes, platelets or plasma proteins | symptoms: chest tightness, flank pain, fever, chlls, increased heart rate
53
Hemolytic reaction causes symptoms treatment
causes: ABO or rh incompatible---severe and immediate symptoms: BURN ALONG INFUSION LINE*****OOZING, DYSPNEAA, FLANK PAIN, CHEST PAIN, DECREASED BP IS A LATER SIGN Treatment: stop, dr, o2, fluids, epi, monitor DIC and renal filure
54
how can we ck for a hemolytc anemia
flush with saline if it still burns it is blood if not it is IV
55
Plasma Protein Incompatibilty
cause is immunoglobin A incomp symptoms:abdominal pain, fever,chills, dyspnea, later decreased BP treament stop dr oxygen fluids, epi, corticoids
56
Exogenous Reactions
externl factors in administration of blood - bleeding tendency - hypothermia - ciculatory overload - hypocalcemia - hyperkalemia
57
Bleeding Tendencies is a _______ cause symptoms Treatment
Bleeding Tendencies is a exogenous reaction=blood dont like me cause: decreased latelet ct in stored blood symptoms:blleding, bruising, oozing Treatment: physician, platelets, FFP,Cyroprecipitate, monitor platelet ct
58
circulatory overload is _______reaction cause: Symptoms: Treatment:
circulatory overload is Exogenous reaction cause: too rapis infusion Symptoms: dyspnea, crackles, JVD, HTN, tachy Treatment: dr, stop, diuretics, monitor Vs, and o2
59
Hyperkalemia is_______ cause: symptom: treatment:
Hyperkalemia is an exogenous cause: increased potassium in stored plasma by lysis of RBC symptom: brady and peaked T waves treatment: dr,12 lead, elec levels, kayexalate, glucose, insulin, hydrate
60
Hypocalcemia is: cause: symptom: treatment:
Hypocalcemia is exodogenous cause: citrate-treated blood binds w/ ca symptoms: arrythmias, decreased BP, muscle cramps, tingling Treatments: Dr. Stop/slow,calcium gluconate
61
Hyppothermia is_______
hypothermia is a exogenous reaction cause: rapis infusion of lg amounts of blood symptoms: slow or stop infusion treatment: warm pt w/ blankets, blood warmer is hardly used

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