BLD 435 EXAM 3 QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS VERIFIED LATEST UPDATE
adverse outcomes in transfusion reactions
anything that happened that wasn't predicted or planned and can lead to fatalities or
disabilities.
nurse will monitor BP, Temp, HR, RR, and alerts lab if adverse outcomes appear
key to successful outcome
- early recognition
- prompt cessation of infusion
- further evaluation
immediate transfusion infections
- within 24 hrs
- immune
- non-immune
- transfusion related species
- severe/mild allergy
- TACO
- complications of massive transfusion
- febrile non-hemolytic (fever-like symptoms, most common)
febrile non-hemolytic transfusion reaction (FMHTR)
,- fever & chills
- anti-wbc (anti-HLA) or platelets
- most common, usually mild
- ("non-hemolytic" = not destroying rbc)
acute hemolytic transfusion reaction (ATHR) - statistics
biggest risk is ABO
1: 80,000 of ABO AHTR risk
1: 1,800,000 of death
~1/4 of deaths reported to FDA
acute hemolytic transfusion reaction (ATHR)- intravascular
- heat along vein
- flushing
- lumbar pain
- fever and chills (can be severe - "bed shakes")
acute hemolytic transfusion reaction (ATHR) - extravascular
- delayed fever and chills
allergic reactions
- urticaria ("hives")
- anaphylactic (patient without IgA??)
- prompt cessation to inhibit the reaction from getting worse, give patient anti-histamine,
wash rbc to eliminate plasma
transfusion associated circulatory overload (TACO)
, - pump too much blood too soon
(patients at risk:)
- cardiac patients
- pulmonary disease
- anemia
- infants
transfusion related acute lung injury (TRALI)
- hard to differentiate betweejn TACO, TRALI, sepsis and anaphylactic allergic reactions
- due to:
- cytokine load from unit
- anti-HLA antibodies (bind & destroy wbc which causes an immune response)
- dead neutrophils will release a ton of cytokines
- donors exposed to HLA (transfused a lot, pregnant women)
massive transfusion complications
- metabolic (citrate & K+ --> anticoagulants)
- hemostatic abnormalities
- immune hemolysis
- air embolism
FFP (fresh frozen plasma)
indications: pts who need coagulation factors - liver failure, DIC, massive RBC
transfusion
Product of choice for pts with multiple deficiencies
platelets
COMPLETE SOLUTIONS VERIFIED LATEST UPDATE
adverse outcomes in transfusion reactions
anything that happened that wasn't predicted or planned and can lead to fatalities or
disabilities.
nurse will monitor BP, Temp, HR, RR, and alerts lab if adverse outcomes appear
key to successful outcome
- early recognition
- prompt cessation of infusion
- further evaluation
immediate transfusion infections
- within 24 hrs
- immune
- non-immune
- transfusion related species
- severe/mild allergy
- TACO
- complications of massive transfusion
- febrile non-hemolytic (fever-like symptoms, most common)
febrile non-hemolytic transfusion reaction (FMHTR)
,- fever & chills
- anti-wbc (anti-HLA) or platelets
- most common, usually mild
- ("non-hemolytic" = not destroying rbc)
acute hemolytic transfusion reaction (ATHR) - statistics
biggest risk is ABO
1: 80,000 of ABO AHTR risk
1: 1,800,000 of death
~1/4 of deaths reported to FDA
acute hemolytic transfusion reaction (ATHR)- intravascular
- heat along vein
- flushing
- lumbar pain
- fever and chills (can be severe - "bed shakes")
acute hemolytic transfusion reaction (ATHR) - extravascular
- delayed fever and chills
allergic reactions
- urticaria ("hives")
- anaphylactic (patient without IgA??)
- prompt cessation to inhibit the reaction from getting worse, give patient anti-histamine,
wash rbc to eliminate plasma
transfusion associated circulatory overload (TACO)
, - pump too much blood too soon
(patients at risk:)
- cardiac patients
- pulmonary disease
- anemia
- infants
transfusion related acute lung injury (TRALI)
- hard to differentiate betweejn TACO, TRALI, sepsis and anaphylactic allergic reactions
- due to:
- cytokine load from unit
- anti-HLA antibodies (bind & destroy wbc which causes an immune response)
- dead neutrophils will release a ton of cytokines
- donors exposed to HLA (transfused a lot, pregnant women)
massive transfusion complications
- metabolic (citrate & K+ --> anticoagulants)
- hemostatic abnormalities
- immune hemolysis
- air embolism
FFP (fresh frozen plasma)
indications: pts who need coagulation factors - liver failure, DIC, massive RBC
transfusion
Product of choice for pts with multiple deficiencies
platelets
