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Liz's Blood Bank Module 2 > Transfusion Therapy (Need to finish) > Flashcards

Flashcards in Transfusion Therapy (Need to finish) Deck (70):
1

List the signs and symptoms of anemia

- Generalized weakness
- Headache
- Dizziness
- Disorientation
- Breathlessness
- Palpitations
- Chest pain
- Pallor
- Tachycardia

2

Transfusion of RBC products
- Primary indication

Anemia

3

Transfusion of RBC products
- Tests indicating transfusion is necessary

- Hematocrit: ≤ 21%
- Hemoglobin: ≤ 7 g/dL

4

Transfusion of RBC products
- Expected rise in Hgb and hct values per unit of RBCs transfused

One unit should raise the hemoglobin by 1 g and hematocrit by 3%

5

Transfusion of RBC products
- Compatibility requirements

All red cell products MUST have some kind of XM (electronic, IS, or AHG)
- ABO/Rh compatibility is REQUIRED
- If whole blood is given, it must be ABO IDENTICAL

6

Transfusion of RBC products
- Contraindications to RBC transfusion

?

7

List red cell products

- Leukoreduced packed cells
- Washed packed cells
- Frozen/deglyc'd packed cells

8

List indications of leukoreduced packed cells (LPC)

- Febrile TX reactions
- Prevention of HLA Abs
- Oncology, transplant, neonate patients

9

List indications of washed cells (WC)

- IgA deficient patients
- EKMO patients/babies
- Removal of anticoagulant or ↑ K+

10

List indications of frozen/deglyc'd cells (FC)

- IgA deficient patients
- Rare phenotypes

11

Which blood product is capable of carrying CMV?

WBCs

12

Which blood products are capable of transmitting CMV?

RBCs and platelets

13

Which blood products are considered "CMV safe", if CMV negative units aren't available?

Leukoreduced and/or frozen/deglyc'd

14

Which 3 patient populations are at the highest risk for CMV infection if transfused w/ a CMV positive donor unit?

- BM transplant patients
- Infant/neonatal patients
- Pregnant women

15

What is the purpose of irradiation of blood products?

?

16

List recipient conditions requiring irradiated blood components

?

17

Calculate the expiration date of irradiated blood products

?

18

Transfusion of platelet products
- Primary indication for transfusion/clinical symptoms

- ↓ production
- ↑ destruction
- Splenic sequestration

19

Transfusion of platelet products
- Tests indicating transfusion is necessary

- < 50,000/uL for "therapeutic" platelet TX
- 10,000-20,000/uL for patients w/ chemotherapy-induced thrombocytopenia

20

Transfusion of platelet products
- Expected rise in platelet count for transfused random platelets

Should increase platelet count by 5-10,000/uL for each unit

21

Transfusion of platelet products
- Expected rise in platelet count for transfused platelet pheresis ("single-donor platelets")

Should increase platelet count by 20,000-60,000/uL

22

Transfusion of platelet products
- Compatibility requirements

ABO compatible preferred

23

Transfusion of platelet products
- Contraindications to platelets transfused

?

24

How is platelet transfusion effectiveness assessed?

- Observation of stopped bleeding
- Look for refractoriness

25

Transfusion of granulocytes
- Primary indication for transfusion/clinical symptoms

Severe neutropenia (< 500/uL) and serious bacterial or fungal infection

26

Transfusion of granulocytes
- Compatibility requirements

ABO compatibility is required

27

Transfusion of granulocytes
- Effect of irradiation

RBCs become less contaminated?

28

Transfusion of plasma products
- Primary indication for transfusion/patient conditions

?

29

Transfusion of plasma products
- Tests indicating transfusion is necessary

PT/PTT > 1.5x reference range

30

Transfusion of plasma products
- Compatbility requirements

ABO compatibility preferred

31

Transfusion of plasma products
- Contraindications to a plasma transfusion

?

32

____ is whole blood that was frozen w/in 8 hours of collection

FFP (fresh frozen plasma)

33

____ is from whole blood frozen w/in 24 hours of collection

PF24 (plasma frozen w/in 24 hours)

34

____ is plasma collected by apheresis

AFFP (apheresis fresh frozen plasma)

35

____ is plasma left over after production of cryoprecipitate

CRP (cryo-reduced plasma)

36

____ is derived from FFP and PF24 that has been thawed in a closed system

Thawed plasma

37

Transfusion of cryoprecipitate
- Primary indication of transfusion

- Fibrinogen (with/out active hemorrhage)
- Factor XIII
- Fibrin glue
- von Willebrand's disease

38

Transfusionof cryoprecipitate
- Tests that indicate a transfusion is necessary

- Fibrinogen deficiency: < 100 mg/dL
- Fibrinogen deficiency w/ hemorrhage: < 150 mg/dL

39

Transfusion of cryoprecipitate
- Compatibility requirements

ABO compatibility preferred

40

Transfusion of cryoprecipitate
- Contraindications to a cryoprecipitate transfusion

?

41

Alternative treatments for cryoprecipitate products

- Factor VIII concentrate
- Factor IX concentrate
- Novo Seven
- Immune Globulins (IVIGs)
- DDAVP
- Iron therapy/vitamin B12/folic acid
- EPO/Procrit

42

Coagulation therapy for hemophilia A

- Factor VIII
- Novo Seven
- DDAVP

43

Coagulation therapy for hemophilia B

- Factor IX
- Novo Seven

44

Coagulation therapy for von Willebrand's disease

- Factor VIII
- DDAVP

45

Coagulation therapy for Factor XIII deficiency

?

46

Coagulation therapy for multiple coagulation deficiencies

FFP

47

Coagulation therapy for liver failure

?

48

Coagulation therapy for hypofibrinogenemia

Cryoprecipitate

49

Coagulation therapy for TTP

FFP

50

Why is Rh compatibility not important when choosing donor types for plasma product transfusions?

Does not contain RBcs or platelets

51

Process of issuing blood to nursing unit or surgery

- Transporter brings "pick-up slip"
- Positive ID of recipient using two identifiers (name and MRN)
- Dispense request sent to blood bank via computer
- Blood product sent to unit via tube system
- BB personnel review identifying info, inspect appearance of component, and ensure there's a system to maintain proper storage during transport

52

Appearance of bacterially contaminated unit

- Purplish color above buffy coat (or cell/anticoag layer) or air seen in bag

53

Proper labeling of unit

- Tie tag or label must include: name, identifying # of intended recipient; component unit #; interpretation of compatibility tests if performed
- Expiration date

54

Corrective action if unit fails inspection

?

55

Process of returning blood when TX delays are encountered or if blood isn't used in surgery

Should be returned to blood bank for storage unless TX can be completed w/in 4 hours
- Should not be left at RT ro stored in unmonitored fridge
- Blood is viable only for 30 minutes if not issued in validated ice coolers

56

Most important step to ensure safe transfusions?

PATIENT IDENTIFICATION

57

Only acceptable additive solution to a unit of blood

Normal saline

58

Maximum time that a unit can be transferred to a patient

4 hours

59

Purpose of infusion sets

Retain blood clots and particles potentially harmful to recipient

60

Purpose of blood warmers

Needed if cold blood is infused very rapidly (or in trauma settings) to reduce risk of cardiac arrest

61

What patient population need blood warmers?

- Patients w/ cold agglutinins
- Infant exchange TX

62

Purpose of mechanical pumps

Deliver infusions at a controlled rate

63

What patient population need mechanical pumps?

Peds and neonates

64

Purpose of pressure devices

Infuse blood very rapidly most often in surgery

65

How is a patient monitored during a transfusion?

- Transfusionist should stay w/ patient for first 15 minutes (start w/ slow rate of 2mL/minute; severe rxns occur w/in first 25 mL)
- Vital signs taken every 15 minutes; if all is good, increase rate to 4 mL/minute
- Observe patient periodically throughout TX (~30 minutes) and up to 1 hour after transfusion

66

What should be done when a potential transfusion reaction is suspected?

STOP THE TRANSFUSION and call the doctor immediately

67

Which units are placed on the "Emergency Shelf" in most hospital blood banks?

2 units of O= and 2 units of O+

68

In an emergency situation, give ____ to females of child-bearing age or males younger than 13 years old

O neg

69

In an emergency situation, how is emergency blood released?

Physician must sign a release form

70

Why does a neonate require less than 7 day old RBCs?

Reduces risk of hyperkalemia and maximize 2,3-DPG