Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
19 Cards in this Set
- Front
- Back
|
Types of Transfusion Rxns:
Acute Reactions |
-mins-hours, during or after trans
1. Immunologic - by Ab-Ag process 2. Non-immunologic - by processes other than Ab-Ag such as VOL OVERLOAD |
|
|
"TACO"
|
Transfusion Associated Circulating Overload = 2nd MCC transfusion death
-responds to diuretics |
|
|
Acute Immuno Rxn:
Dermal |
1. S/S: hives (MC trans rxn), pruritis, erythema
2. Etiology: sensitization to foreign Ig to skin and release of histamine 3. Tx: slow transfusion, give antihistamine |
|
|
Acute Immuno Rxn:
Febrile Non-hemolytic transfusion reaction |
1. S/S: fever, chills, myalgia, headache, tachypnea
2. Etiology: anti-WBC or anti-platelet Ab in sens pt 3. Tx: stop transfusion, **Must R/O hemolysis -fever w/out hemolysis by pyrogen in plasma or on a cell |
|
|
Acute Immuno Rxn:
Pulmonary transfusion related Acute Lung injury "TRALI" cont'd S/S |
-acute onset hypoxemia w/in 6 hrs of blood component transfusion
-a/w "white out" of frontal chest x-ray w/out other disease |
|
|
Acute Immuno Rxn:
Pulmonary transfusion related Acute Lung injury "TRALI" cont'd Etiology and TX |
-Ab-Ag complex injures cells lining alveoli--> loss of fxn
-Extravasc fluid fills lung space and air holes fill -**Pt recovers spontaneously, supportive care, DOES NOT respond to diuretics |
|
|
Acute Immuno Rxn:
Pulmonary transfusion related Acute Lung injury "TRALI" cont'd SPECIAL NOTES: |
-MCC transfusion related death in last 3 yrs
-NO hemolysis -Prognosis GREAT if ID and tx early -DDx pulmonary embolus, CHF, ARDS |
|
|
Acute Immuno Rxn:
Hemolytic Rxn |
1. S/S: chest/back pain, fever, shock, dark urine, renal fail, DIC
2. Etiology: Anti-RBC Ab w/ complement fixation and RBC destruction (incompatible transfusion) 3. Tx: supportiv care, keep pt alive, STOP Transfusion |
|
|
What is going on in an incompatible transfusion?***
|
-RBC given w/ Ag corresponding to pt's IgG--> hemolysis
-causes low serum haptoglobin** |
|
|
Delayed Transfusion Reaction
Immunologic |
-Hemolytic - up to 10 days after
-Blood originally compatible b/c amount of Ab in recipient plasma undetectable, when re-exposed HUGE inc in Ab# --> Acute intra/extravasc hemolysis |
|
|
Delayed Transfusion Reaction
Non - Immunologic*** |
-IRON OVERLOAD - to organs --> cirhosis/failure --> death
-Oral tx solubilizes iron "overload iron chelating agents" for pts w/ long-term transfusion needs |
|
|
ABO BLOOD GROUP TABLE
|
MEMORIZE 2 TQs
|
|
|
Sugars are antigenic meaning?***
|
-give "A" sugar to "B" pt --> pt will build Anti-A Ab
-if have Ag inside self, you will NOT have Ab to self -***may NOT receive blood from a donor w/ Ag to which you have an Ab--> INCOMPAT Transfusion |
|
|
Rh - "Big D Protein" IgG
|
-if inherit from either parent, then Rh POS
-if DO NOT inherit Rh NEG -no natural Rh on bacteria -Persons do not build Anti-D unless exposed - via transfusion or pregnancy w/ maternal bleed/amniocentesis |
|
|
NOTED EXAMPLE:
|
Rh NEG mother, 1st fetus is Rh POS, so mother will build Anti-D Ab. Next preg if fetus is Rh POS, mother's Anti-D will destroy the fetal cells--> HEMOLYTIC DISEASE OF THE NEWBORN!
-mom should get Rho-Gam Ig that suppresses Anti-D form |
|
|
What is the best way to prevent HDN?***
|
-NEVER profuse Rh POS blood into Rh NEG woman (of child-bearing age) or a pt w/ Anti-D
-only ok if older woman (not of child-bearing age) or man -can give Rh POS man until forms Anti-D Ab, but ONLY if the supply is very low and no Rh NEG is available |
|
|
What are some diseases transmitted by transfusion?
|
-Hep (safer than ever)
-HIV/AIDs -HTLV -CMV -Bacteria -"Lues" - syphilis (rare) |
|
|
HIV/AIDS Transmitted by Transfusion
|
-Type 1, 2, O
-Risk extraordinarily low but NOT 0 -1 in 2 mil (2 cases/yr in US) |
|
|
****INFORMED CONSENT FOR TRANSFUSION
Must contain all required elements: |
1. Expected benefits
2. Possible Risks 3. Alternative therapies 4. Understandable language 5. Chance to ask questions |
