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36 Cards in this Set
- Front
- Back
What part of the blood carries oxygen? |
Hemoglobin |
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What is the role of blood? |
1. Supplies O2 & nutrients for energy production, growth and repair 2. Transports cellular waste to be excreted 3. Provides defense against infection by transporting antibodies 4. Regulates body temperature 5. Maintain acid-base balance 6. Regulate Fluid & Electrolyte |
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Which blood type is a universal donor? |
Type O (has no antigens, both antibodies) |
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Which blood type is a universal recipient? |
Type AB (has both A & B antigens, no antibodies) |
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What happens is the blood transfused is incompatible? |
Antibodies trigger RBC destruction |
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What are the basic components of blood? |
1. Plasma (55% of blood volume) 2. Formed Elements: RBC, WBC, Platelets (45% of blood volume) |
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What does plasma consist of? |
Serum, protein, lipids, electrolytes, vitamins, CHO (carbohydrates), urea, bilirubin, gases |
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What are the objectives for a blood transfusion? |
1. Maintain blood volume 2. Maintain O2 carrying capacity (hemoglobin) 3. Maintain coagulation (platelets) |
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When is whole blood transfused? |
For acute hemorrhage & hypovolemic shock (loss more then 1L of blood) |
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If a person is anemic, which component of blood would you transfuse? |
packed RBC |
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If a person has clotting issues, which component of blood would you transfuse? |
platelets or fresh frozen plasma |
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What components is the whole blood broken into for transfusion? |
1. RBC 2. WBC 3. Plasma |
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RBC (packed cells) |
90% of the plasma has been removed to increase O2 carrying capacity without fluid overload. |
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WBC |
Leukocytes concentrate to increase WBC count -for leukemia patients -for immunity depression from treatment |
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Plasma |
Contains fresh frozen plasma and platelet concentrate
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Fresh frozen plasma |
It contains most clotting factors except platelets. It is used when the clotting factor is unavailable or bleeding factor is unknown. |
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What is Cryoprecipitate? |
fresh frozen plasma containing factor 8 given to hemophiliacs (men who have a deficiency of factor 8 and cannot clot. |
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What is Serum Albumin? |
Restores blood volume by increases plasma protein. It is hypertonic (pulls water and puts it into the vascular system). It is used for patients with burns or severe protein deficiency. *plasma protein fraction is the same |
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Platelet Concentrate |
Concentration of platelets with very little plasma to prevent bleeding. -thrombocytopenia - low platelet count |
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What is Autologous transfusion? |
collection and reinfusion of a patient's own blood. |
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Why are autologous transfusions safe? |
They decrease the risk of blood incompatibility and exposure to bloodborne infectious agents. |
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What are the methods of autologous blood collection? |
1. Scheduled prior to pre-op. Can be donated starting 6 weeks pre-op, every 3 days, up to 72 hours prior to surgery. 2. Hemo-dilution - Performed in the OR during surgery. Blood is removed and replaced with IV fluid to maintain volume. 3. Salvage from operation site (reuse or wash and reuse for packed cells) 4. Closed drainage system. Reinfused with 4 hours. |
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How does a nurse prepare for a blood transfusion? |
1. Assess the patient & record baseline vitals first (must be stable) 2. Teach patient symptoms of adverse reactions 3. Consent! 4. Assemble equipment (start IV/saline lock if central line not in) 5. Obtain blood |
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What are the common meds given prior to a transfusion? |
tylenol and benadryl |
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What size gauge needle is needed for blood transfusion? |
Size 19 because the RBC's are size 19. Anything smaller will slow transfusion and damage RBC. |
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What fluid is used to transfuse blood? |
0.9% normal saline only! -D5 (Dextrose) will hemolyze the RBC's -Lactated ringer's will cause blood to clot in bag and tubing due to calcium |
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What kind of tubing is used for the blood transfusion? |
Y-line tubing (one side goes to the blood and one goes to the saline) with in-line filter to catch clots or debri. |
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When does the filter/tubing need to be changed? |
Every 4 hours or after 2 units of blood. |
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How long can the blood bag stay out of the blood bank for before it is considered not usable? |
30 minutes |
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Verification process once blood is obtained |
*Requires 2 nurses (one can be an lpn) 1. Inspect the blood 2. record serial numbers on the tab 3. Compare with patient's blood tag 4. Identify the patient -compare name of pt to name on blood -ask pt to state name |
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Flow rate of a blood transfusion |
1. Start slowly. No more than 2cc per minute (30-50cc within first 15 minutes) 2. Regulate to the rate dr. ordered after the first 15 if there are no adverse reactions. 3. Do not exceed 4 hours |
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When is an adverse reaction likely to occur during a blood transfusion? |
Within the first 15 minutes. |
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When are vitals required? |
-prior to transfusion (baseline) -every 15 minutes for the first 30 minutes (twice) -every 30 minutes until transfusion is complete |
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What is a non-hemolytic reaction? |
-fluid overload (seen when given whole blood) -fever (immune response) - temp increased 1.8 or more from baseline -hives or rash (immune response) -severe allergic anaphylactic shock -Infection (Hep, AIDS, HIV, Malaria, Virus, etc) |
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What is a hemolytic reaction? |
Can be life threatening: 1. Delayed (more common) - caused by incompatibility of antigens besides ABO 2. Acute (most serious) - caused by ABO blood group incompatibility (like wrong blood given). |
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What are the nurses actions if reaction occurs? |
1. Stop the transfusion completely / Change tubing / Keep saline running (in new tubing) 2. Notify dr. & wait for order 3. Recheck labels for errors 4. Monitor vitals 5. Follow dr. order based on symptoms 6. draw blood / collect urine / monitor urine to watch for kidney function 7. If shock - shock position / O2 / and resuscitate |