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29 Cards in this Set
- Front
- Back
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indications for a transfusion
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1. decreased blood volume, 2 correction of insufficient o2 carrying capability
3 replace coagulation componets |
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composition of blood
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cells = 45%
Plasma = 55% = liquid part of blood which is 90% water and 10% solute |
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What are antigens in the ABO system
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protein located on cell surface of RBC
capable of stimulating an antibody then reacting with antibody in a certain way |
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Blood A
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has a antigen and can receive A or o blood
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Blood type B
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has B antigen can receive B or O
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Blood type AB
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has A and B antigens can receive A, B or AB or O
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Bloody type O
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Doesn't have either antigen
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Antigen D
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is on RBC and if it is RH positive it is present if RH negative no antigen
positive blood can have + or - negative can only have - |
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Antibodes:
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protein substances in the PLASMA some occur naturaly
some develop d/t a response to stimulation by an antigen |
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HLA human leukocyte antigens
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on surface of lymphocytes and other nucleated cells. d/t frequency of exposure ie: sickle cell / chemo patients
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when is whole blood used:
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symptomatic anemia
large volume deficit usually when loss is > 25% 1 unit = 500 mls |
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Packed red blood cells
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1 unit = 250 mls takes 6 donor for 1 unit
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Leukcocyte-poor
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RBC used for patinets who have had febrile reactions from leukicyte antibodies
usually chemo patients |
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Fresh Frozen Plasma
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For defiit of labile and stale plamsa coagulation factors
just liquid portion of blood for clotting factors |
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Plateletts
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bleeding from thrombocytopenia or platelet function abnormality: no microaggregate filer = given per GRAVITY <20,000
1 unit will increase by 5 to 10K |
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Pretransfusion steps
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1. obtain medical history / any prior infusions / reactions
2 check for order and signed consent 3 draw, type & screen blood 4.gather supplies 5. do heat to toe assessment & V.S. |
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transfusion
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obtain blood product = verify blood and patient via 2 rn's
assess patient, monitor the patient and stay with patient first 15 minutes |
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post transfusion
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flush with NS
dispose of according to facility's policy assess patient for adverse reactins for at least 1 hour post infusion |
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transfusion reminders
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fluid over load usually happens w/in 1st hour
transfuse as quickly as possible but must be done w/in 4 hours iv site is used solely for blood with no smaller than 20 gauge needle usually 18 |
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Accute Hemolytic transfusion reactions:
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Accute = usually antigen-antibody reactions most occur w/in 1st 15 to 30 min. best to infuse first 50mls slowly
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Delayed hemolytic transfusion reaction
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usually antibodies are undetectable at time of transfsion
patients having this reaction have usually been sensitized to the antigen through previous transfusion |
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Complications of ACCUTE hemolytic reaction
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2ndary to incompatibility between recipients serum and antigens in donor's RBC = agglutination/hemolysis
Most are clinical erros can cause DEATH |
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S/S of accute hemolytic reaction
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headache, chills, chest pain, facial flusing, low back pain, burining alone a vein, anxiety, dyspnea, shock fever
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S/S of delayed hemolitic reation
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continuous fall in hemoblogin 24 hours after up to 14 days later, may have fever, hmoglobunuria, hyperbilirubinemia no tx just tx symptoms
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FEBRILE REACTION
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sensitization to donor's WBC, platelets or plasma proteins>
s/s suddon onset of chills & fever, headache, flushing, anxiety, muslce pain |
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Mild allergic reaction
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Sensitivity to foreign plasma proteins s/s flushing, itching, uticaria
tx: stop transfusion, maintain IV, notify doc may give antihitamines and restart slowly |
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Anaphylactic & Severe Allergic reacton
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sensitivity to donor plasma proteins
anxiety, uricaria, wheezing, progressing to cyanosis, shock and possible cardiact arrest |
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Ciculatory overload
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fluid admin faster than circulation can accomodate
s/s cough, dyspnea, pulmonary congestion, headache, hypertension, tachycardia, distended neck vein |
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MASSIVE BLOOD TRANSFUSION REACTION
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transfusion large volumes of blood it surpasses patient's blood volume
s/s clotting issues, hypothermia, citrate toxicity, hypocalcemia, hyperkalemia hyperkalmia causes N&D, muscle weakness, cardiac arrest |
