Medical Surgery Examination

Medical Surgery Why do patients get blood products? - Answer- 1. anemic w/ a hgb 8-10 2. increase their blood volume 3. they have a clotting disorder 4. surgical blood loss 1200 5. never just b/c List the two main functions of transfusions - Answer- 1. increase O2 carrying capacity of the blood 2. reverse tissue hypoxia What is whole blood given for and how is it transfused? - Answer- -for shock, low blood volume, low Hgb, low Hct, hemorrhage -500 mls over 2-4 hrs PRBC's 1. what must you do first? 2. what must you do for Rh neg? 3. how does it affect the blood? 4. 1 unit = how many mls? 5. what's the infusion rate? - Answer- 1. must be typed and cross matched 2. Rh neg. gets Rh neg. 3. 1 unit increase Hgb by 1g/dL or Hct by 3% 4. 4 unit = 300-350mls 5. 250-300 mls given over 2-3 hrs, completed w/in 4 Leukocyte poor RBC's 1. what are they? 2. who are they given to? - Answer- 1. a blood product in which the WBC's have been removed to reduce risk of reaction 2. patients w/ known nonhemolytic transfusion reactions and imunosuppressed ppl Frozen Fresh Plasma 1. how is it seperated? 2. when is it given? 3. are they cross matched? 4. what's in it? 5. how is it infused? - Answer- 1. seperated via centrifuge 2. to restore plasma volume and treat some bleeding problems 3. no 4. all clotting factors, antithrombin, plasmin protein 5. short half-life means it runs over 30-60 minutes and must be stored frozen, must finish w/in 4 hrs Platelets 1. when is it given? 2. are they cross matched? 3. how are they stored? - Answer- 1. maintain normal coagulability of the blood, given for bleeding disorders and when bone marrow doesn't make enough 2. no 3. room temp w/ agitation, expire after 5-7 days Cryoprecipitate 1. what is it? 2. what factors are in it? 3. when is it given? - Answer- 1. the precipitate after FFP thaws 2. factor VII, vonWillebrand, fibrinogen, factor XIII 3. for fibrinogen levels 100, when there's a factor deficiency that's leading to bleeding What is "type and cross matching"? - Answer- It's a process used to determine blood type compatibility between donor and recipient. Determines Rh and ABO. Rh 1. what is it? 2. who gets + or - ? - Answer- 1. blood factor made of antigens 2. Rh+ gets + or - blood, Rh- gets - blood only ABO 1. who gets what? 2. who's the universal donor and recipient? - Answer- 1. O- doesn't have A, B, or O antigens. AB+ has A, B, and O antigens. 2. O- is universal donor. AB+ is universal recipient. Blood screening checks for...? - Answer- Hep C, HIV, West Nile What religion won't accept blood transfusions? - Answer- Jehovas Witness What are some other blood volume builders? - Answer- crystalloids, artificial crystalloids (dextran) What is an autologous blood donation? - Answer- donation to one's self, good for one month Risks of infusion therapy - Answer- disease transmission (most likely Hep B), bacterial contamination, transfusion rxn, circulatory overload How long after being brought up from the blood bank must the blood be infused? - Answer- 30 minutes What must nurse do to before giving blood? - Answer- positively ID the pt, inspect the blood, 2-nurse verification, verify donor-recipient compatibility, check expiration date, get baseline vitals, start IV w/ 18-20G needle to avoid lysing of cells What must the nurse do after starting a blood infusion? - Answer- Infuse slowly for first 15 min and assess q 15 min, watch for vitals, and check vitals regularly What is the only solution that can be used when giving blood? - Answer- 0.9% normal saline Describe a febrile nonhemolytic transfusion rxn - Answer- 90% of all reactions; fever, chills; recipient's antibodies react to antigens in the donor's blood Describe (TRALI) transfusion-related acute lung injury - Answer- Leading cause of transfusion-related deaths; chills, sudden resp. distress, resp. failure; Allergic vs. febrile vs. hemolytic rxns 1. Symptoms of each - Answer- A. Allergic - facial flushing, hives/rash, increased anxiety, decreased BP, dyspnea B. Febrile - fever, chills, anxiety, headache, tachydardia, tachypnea C. Hemolytic - chest pain, low back back pain, fever, chills, tachycardia, apprehension, decreased BP, increased resp. rate