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Med Surg I > Wk 2 Blood Component Therapy: Nursing Implications > Flashcards

Wk 2 Blood Component Therapy: Nursing Implications Flashcards

(63 cards)

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1
Q

What are four different types of blood products?

A

Packed red blood cells (PRBCs)
Platelets
Fresh frozen plasma
Albumin

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2
Q

What are packed red blood cells?

A

Doesn’t have plasma, wbcs, or platelets

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3
Q

When a patient needs, PRBCs, what will the provider order?

A

Type and cross match

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4
Q

What is a type & cross match?

A

Determines person’s blood type

Determines compatibility between blood specimens, making sure no hemolysis takes place

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5
Q

What is a cross match called?

A

Indirect Coombs test

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6
Q

What type of reaction happens if someone receives a wrong blood type transfusion?

A

Hemolytic

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7
Q

What blood type is the universal donor?

A

O-

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8
Q

What blood type is the universal recipient?

A

AB+

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9
Q

What labs do you need to assess pretransfusion?

A

H&H

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10
Q

For a Hgb <6, a blood transfusion is recommended…

A

except in exceptional circumstances

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11
Q

For a Hgb of 6-7, a blood transfusion is..

A

Likely to be indicated

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12
Q

For a Hgb 7-8, a blood transfusion is…

A

May be appropriate in patients undergoing orthopedic or CT surgery, and in those with stable CVD

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13
Q

For a Hgb 8-10, a blood transfusion is…

A

Not indicated unless symptomatic anemia, hemorrhaging, acute coronary ischemia, thrombocytopenia with high risk of bleeding

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14
Q

For a Hgb greater than 10, a blood transfusion is

A

Not indicated unless in exceptional circumstances

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15
Q

How often should a type & cross match be completed?

A

Every 48 hours

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16
Q

For a blood transfusion, what must a patient do?

A

Sign a consent form

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17
Q

What might be indicated before a blood transfusion?

A

Pre-medicate

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18
Q

About how much volume is given during a blood transfusion with PRBCs?

A

250-350mLs

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19
Q

What size of venous access is needed for a blood transfusion?

A

20 g or larger, 18 g preferred

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20
Q

What type of tubing do you need for a blood transfusion and why?

A

Y tubing with a filter, one port for blood and one for NS

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21
Q

What type of solution can be used with PRBCs?

A

NS ONLY, can’t use D5 or LR because it will cause hemolysis of the cells

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22
Q

Can you hang LR and blood?

A

NO

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23
Q

Can you hang D5 and blood?

A

NO

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24
Q

How much time do you have to get the blood transfusion started once it arrives on the floor?

A

30 minutes, so be ready with supplies before it arrives

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25
If you can't start a blood transfusion within 30 minutes of it arriving, what is the best next nursing action?
Return the blood to the blood bank
26
What is infused first during a blood transfusion?
The blood bag is hung lower and completely transfused first, and then run the bag of normal saline to make sure all of the blood goes into the patient
27
The final identity check of the patient should be done at the bedside with...
Two RNs
28
How long does the nurse stay with the patient when they are receiving a blood transfusion?
15-30 mins
29
What are s/s to lookout for during the initial start of a blood transfusion?
Chills SOB Itching Back pain
30
The nurse should take baseline...
VS before and after 15 mins
31
How slow should you being a blood transfusion for first 15 mins?
1-2 ml/min | 60-120 ml/hr
32
Unless contraindicated, blood transfusions should be given in what amount of time?
2 hrs
33
How often should you take VS during a blood transfusion?
Start, after 15 mins, every hour, and at the end
34
What is the maximum amount of time for a blood transfusion and why?
4 hours because of risk for bacterial proliferation
35
If you don't get all of the blood in within 4 hours, what should you do?
Take the rest of the blood down and notify the HCP that you didn't get it all in
36
If patient is at risk for fluid volume excess, what might the provider order in-between infusions?
Diuretic (furosemide/lasix)
37
Platelets are prepared from...
Fresh whole blood
38
What volume are platelets?
30-60 mls (very small)
39
How many platelet units can be obtained from one donor?
multiple
40
How should platelet units be kept?
At room temperature
41
How long are platelet units good for?
1-5 days
42
How do you prevent clumping in the platelet bag?
Agitate the bag periodically
43
How fast can platelets be administered?
As fast as they can be tolerated
44
Does blood compatibility matter with platelets?
No
45
What are the indications for platelet transfusion?
Platelet count below 20,000
46
Platelets are not the same thing as...
Clotting factors
47
Where are clotting factors found?
Plasma
48
What is fresh frozen plasma?
Liquid portion of the blood separated and frozen
49
What is the volume of fresh frozen plasma?
About 250 pls
50
Does fresh frozen plasma contain platelets?
No
51
Who will receive fresh frozen plasma?
Liver issues Hemophilia Von Willebrand's
52
Is blood compatibility required for fresh frozen plasma?
Yes
53
How long is fresh frozen plasma good for?
Up to a year
54
After thawing, how soon must fresh frozen plasma be used?
Within 24 hrs
55
What are the indications for fresh frozen plasma?
Bleeding cause by deficiency is clotting factors | Fluid volume expander
56
Albumin is a __ and has __ power
colloid, pulling
57
What does albumin do?
Keeps fluid inside the intervascular space
58
What is a normal albumin?
3.5-5
59
Who might be low on albumin?
``` Malnourished Liver disease (can't make albumin) ```
60
Albumin is prepared from...
plasma
61
What percent albumin is oncotically equivalent/isotonic?
5%
62
What percent albumin is oncotically hypertonic?
25%
63
Is blood compatibility important for albumin?
No

Med Surg I (41 decks)

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