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Hematologic disorder

hematologic blood disorders

packed RBC's severe anemia or blood loss
frozen RBC's autotransfusions
Platelets bleeding from thrombocytopenia
albumin hypovolemia from hypoalbuminemia
fresh frozen plasma replace clotting factors
cryoprecipitates provides specific missing clotting factors
fluid compatibility in blood transfusions 0.9% Saline (normal saline)
warmed blood severe bleeding prevent hypothermia
timing 4 hours max
filtering prevents harmful particles, reduce transmission of viruses
washed blood removes all plasma reduce risk of reactions
vital signs before and during transfusion per protocal
s/sx complications of blood administration fever, urticaria, hemolysis, anaphylactic, circulatory overload
stay with patient time during transfusion at least first 15 minutes of transfusion
febrile reaction most common rx to blood admin, risk goes up for each transfusion (fever, chills, back ache)
urticarial rx hives, is minor rx, notify dr, give benedryl
hemolytic rx deadly, incompatible blood, within minutes (back pain, chest pain, chills, fever, SOB, vomiting, impending doom
anaphylactic rx usually sensitive to immunoglobulins, severe gastrointestinal cramping, instant vomiting, uncontrollable diarrhea.
circulatory overload rapid transfusion short amount of time in older patients, chest pain, cough, crackles, wheezes, tachycardia
O+ rh antigen , can get 0-+
0- no antigens, can only get 0-
AB+ antigens for A, B, rh, can get 0, A, B, AB, -+
AB- antigens for A, B, but not Rh, can get only 0, A, B, AB, -
A- antigens for A, not rh, can get A, 0 -
A+ antigens for A, and rh, can get A, 0 -+
B- antigens for B, not rh, can get B, 0-
B+ antigens for B, and rh, can get B, 0 -+
two person verification prevent errors in blood transfusions
blood to lab two person verification
blood to patient two person verification blood transfusion
coumadin PT, INR
heparin APTT
Activated Partial Thromboplastin time (APTT) 25-39 seconds therapeutic range on heparin 1.5 - 2 times
International normalized ratio (INR) normal less than 1.3 range for coumadin 2-3
Normal RBC lab 4.2-5.1
Normal WBC lab 4500 - 11,000
HGB lab 11.7 - 17.3
HCT lab 38% - 49%
sickle cell anemia hemolytic anemia
aplastic anemia bone marrow suppression
B12 anemia no intrinsic factor
folic acid anemia diet lack of folic acid
pancytopenia lack of all blood products being made (bone marrow) aplastic
glossitis s/sx of anemia
petechiae small purplish hemorrhagic spots under skin
universal donar 0-
universal recipient AB+
Prothrombin Time (PT) 9.5-11.8 normal on coumadin 1.5 - 2 times normal
Created by: cbiondillo