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Anne Morel
Blood products and Typing
| Question | Answer |
|---|---|
| What components make up blood? | Plasma, white blood cells, and red blood cells |
| What percentage does plasma make up? | 55% |
| What percentage does white blood cells and platelets make up? | Less than 1% |
| What percentage makes up red blood cells? | 45% |
| What is plasma mostly comprised of? | water--almost 90% |
| what percentage of blood volume do plasma and plasma proteins make up? | 55% blood volume |
| What is plasma and plasma proteins compprised of? | albumin (large protein), fibrinogen (clotting), and antibodies (globulins) |
| How are plasma and plasma proteins given? | As Fresh frozen plasma in transfusions |
| Cryoprecipitate is derived from...? | plasma and given through transfusions |
| What is a function of plasma and plasma proteins? | For blood pressure, maintain osmolality, and pH of blood |
| The albumin in plasma proteins functions to....? | regulate water and solutes through the capillaries. |
| What kind of molecule is albumin? | A carrier molecule |
| Where is albumin synthesized? | The liver |
| What action does albumin have? | The substances in the blood attach to albumin |
| What is another plasma protein? | Immunoglobulin |
| Where is it synthesized and what does it do? | By the lymphocytes and it is the defense against infections! |
| Wnat is another plasma protein? | Fibrinogen |
| What purpose does fibrinogen serve? | In the clotting factors |
| The lipoproteins in the last plasma protein...what is it? | Triglycerides, cholesterol, and fatty acids in the blood. |
| Red blood cells are given as... | Packed red blood cells PRBC's |
| Are Red blood cells preferred over whole blood? | Yes, because then they can take out things that they want to donate. |
| What to red blood cells contain? | Hemoglobin and carry O2 to tissues |
| How long do RBC's live? | 120 days |
| For low blood counts what lab values do we want to raise? | Hgb and Hct |
| Describe platelets | Disk shaped fragmentsthat are different shapes and sizes, they have a concave shape which allows for diffusion of gas into a cell |
| Can they change shape? | Yes, in order to get into a cell--smaller ones They can also change shape with anemia. |
| What is the function of platelets? | Coagulation and the control of bleeding |
| Where are 1/3 of the platelets housed? | the spleen--then they go to the spleen after they die to be filtered out again |
| How long do platelets live? | 5-9 days |
| What are white blood cells? | Leukocytes |
| what is the function of WBC's | circulate and defend! |
| What are two types of leukocytes? | granulocytes and agranulocytes |
| What are granulocytes? | Neutrophils, eosinophils, basophils a transfusion is RARE |
| What are agranulocytes? | Monocytes and lymphocytes |
| The typing system is determined by? | the presence of antigens and known as the ABO system |
| What are the four types? | A B AB and O |
| O is the universal donor why? | No antigens on RBC's |
| AB is the universal......? | recipient |
| What antibodies are on O blood | anti A and anti B |
| Who can O give to ? | O |
| What antigen is present on A? | A |
| Who can give to A? | A and O |
| What antibody is on A? | ANti B |
| What antigen is onB? | B |
| What antibody is on B? | anti A |
| Wo can give to B? | B and O |
| What antigen is on AB? | A and B |
| What antibody is on AB? | None |
| Who can give to AB? | A B AB and O |
| What do the antibodies do? | attacks that particular blood |
| What happen if you transfuse with the wrong blood type? | Your own blood type attacks your body and your RBC's and the RBC's split apart and you DIE! |
| Does nRh positive has which antigen? | yes |
| Does Rh negative have an antigen? | no |
| Are most people Rh positive or negative? | Positive |
| What is the most common antigen out of the 27 types of antigens with rh? | antigen D |
| Which pregnancy does rh usually affect? | second |
| What happens when rh positive is exposed to ph negative? | have a bad reaction and the RBC's split apart. |
| how soon are the antibodies formed after birth? | 3 months |
| Hemolytic is the term meant for....? | 2nd exposure |
| If the bleed time is down what happens to dehydration? | It goes up |
| HCt has how many mor times the Hgb? | 3X |
| What does MCV mean? | mean corpuscle volume--average size of RBC's |
| If the Hgb is down what happens to Hct? | It has a proportional relationship |
| If the neutrofils are up what kind of infection do you have? | a bacterial |
| If lymphocytes are up what kind of infection do you hae? | viral |
| Red cell distribution ahs to do with what? | the size shape and width of RBC's = anemia |
| Hgb normals | W 12-16 M 13.5-18 |
| Hct normals | W 38-47 M 40-54% |
| RBC normals | W 4-5 M 4.5-6 |
| MCV normals | 82-98 |
| Neutrophils normals | 50-70% |
| Eosinophils | 2-4% |
| Lymphocytes | 20-40% |
| Monocytes | 4-8% |
| Platelets normal | 150,000-400,000 (150-400) |
| Sed rate--inflammatory marker | varies |
| PT | 12-15 seconds |
| PTT | 60-70 seconds |
| INR | 2-3 |
| Fibrinogen-clotting factor | 200-400 |
| What happens if you have less than 100,000 platelets? | Thrombocytopenia |
| What happens is you have less than 20,000 platelets? | you hae spontaneous bleeding or hemorrhage |
| Immature neutrophils are called what? when do they come out? | bands--acute onset of infections |
| what are reticulocytes? | immature RBC's |
| What will the RBC count show when the RBC's are trying to make more RBC's? | An increase |
| What happens in sickle cell anemia with reticulocytes? | there is an increase. |
| What are indications for a transfusion? | excessive blood loss, anemia, thromocytopenia, clotting abnormailities, hemophilia, bone marrow malfunction, restoration of blood products, trauma and surgery. |
| What to PT and PTT measure? | How fast the blood clots. If the time is decreased there is bleeding--low clotting time. |
| Do people have troouble receiving large transfusions? Why. | Yes--b/c if receive 6-8 units they could have clotting problems. |
| What are types of transfusions? | whole blood-RARE, PRBC, FFP, platelets, ALbumin, Cryoprecipitate, autologous--autotransfusion |
| PRBC's usually come in how many units? | 1 unit |
| SHould you use it right away? what if you cant use it right away? | yes, return it to the blood bank immediately. |
| What is the funtion of PRBC's | to restore and maintain O2 carrying capacity, correct anemia, correct blood loss, and increase RBC mass |
| What are some advantages to using PRBC's? | prevents FVE/ fluid overload, fewer risks of metabolic complications from antibodies in whole blood, and allows other blood products to be takes from whole blood donation |
| How soon must a tranfusion be completed? what happens if not? | within 2-4 hours--septicemia |
| Are PRBC's filtered during transfusion? | yes |
| Why is FFP given? | to restore volume and stays in vasculature longer, and helps with BP, corrects coagulopathies,(INR,PT,PTT, replacement of a sepcific factor when it is not available, correct PRBC problems |
| What is the time period FFP must be given? | within 1-2 hours |
| Is FFP expensive | Duh.. |
| Can a large volume transfusion of FFP cause hypocalcemia? | yes--you could put it is citric acid as it binds with calcium. |
| FFP can also help correct a deficiency from what disease? | liver disease. |
| How many units do platelets come at a time? | 1 unit= 30-60 ml can be more |
| Should you return if not used right away? | yes |
| Platelets can be infused fast or slow? | pretty quickly--RBC's slower |
| Why are platelets given? | decreased production, increased destruction, massive transfusion, lwukemia or marrow aplasia, pre-op for low platelets |
| Are platelets filtered during transfusions? | yes |
| What should you give prior to transfusions? | Benadryl or Tylenol |
| There are usually some reactions. Can you usually still proceed with transfusions? | Usually |
| What should you always ask the patient before tranfusing? | Have you ever gotten them before...reactions, fever? |
| Do platelets have their own set of tubing for transfusions? | yes, b/c the platelets can stick and have to have the special kind. |
| What is the process called taking from a donor? | Apheresis |
| What is albumin? | A colloid |
| Does it stay in the vasculature longer? | Yes--longer than a crystalloid like NS |
| HOw does Albumin come? | In a glass container with its own tubing |
| How quickly should you give albumin? | As quickly as tolerated |
| How soon should you give albumin? | As soon as opened. |
| What is the consistency of albumin? | sticky |
| Why don't you need to worry about typing and cross matching? | b/c it comes in a box |
| How many ml does cryoprecipitate come? | 10-20ml |
| How does it come? | frozen--give when thawed and infuse immediately |
| What is the funtion of cryoprecipitate? | to treat bleeding problems including disseminated intravascular coagulation. |
| When is autotransfusion used | during surgery |
| What should you do before transfusions? | a blood unfusion kit with a filter |
| Do you prime a blood kit like a normal IV set? | yes |
| When you spike the other port with the blood product what comes through? | the blood |
| what do you need to obtain and monitor for after infusion starts? | vital signs and fever. |
| Should you ever give anything else in the same line with blood? | NO! |
| Is a blood tranfusion with an adult run through a pump? | no--goes through gravity |
| Why do you not use a pump? | can lyse the blood products |
| Can you run blood through pumps with peds? | yes |
| What should you do during a transfusion? | Monitor vs for 15 minutes and stay in the room at the bedside. If a life threatening reaction is going to occur it will happen in the first 15 minutes. |
| How ofter should you monitor vs? | q 15-30 minutes until transfusion is complete. |
| If a pt. is at risk for CHF would you run slower? | yes |
| Follow hospital policy on time if not given and stop if when? | a reaction occurs and call the dr.!!!!!! |
| can you flush the tubing with NS? | NO--can give more blood product by flushing the line blood product is still in the line! |
| What are some transfusion reactions? | Hemolytic reaction--immunologic |
| What are the syptoms of a hemolytic reaction? | fecer, back pain, SOB--stop transfusion-- |
| Should you always ask the pt about previous transfusions and reactions? | yes |
| Always type and what before a transfusion? | cross |
| What steps should you take before transfusing into pt? | Double check order, blood product in hand, patient arm band. |
| What is albumin percentage compilation given? | 5 or 25% |
| When is albumin given? | for volume replacement after shock, burns, trauma, surgery, to treat hypoproteinemia, rare allergic reactions, no cross matching needed, rare transmission of viruses |
| What is cryoprecipitate? | part of plasma with rich clotting factors ...factor VIII and VOn Willebrand, and factor XIII |
| Why is croprecipitate used? | to precent or control bleeding, in hemophiliacs, multiple coagulation deficiencies, and those on anticoagulant treatment. |
| what is autologous or autotransfusion? | removal of one's own blood for tranfusion to be used at a leter time during surgery |
| When is autotranfusion done? | startiong 6 weeks before surgery |
| Autotranfusion is used in peri and ... | post op care to give back to the patient |
| IVIG is... | from plasma and given for autoimmune processes |
| Granulocytes are collected by ? | apheresis and given within 24 hours of collection --experimental.... |
| During tranfusion should you use a large bore IV? what gauge? | yes--adult 20-18 gauge needs to be or lyses RBC's |
| MAke sure you check your blood with another... | RN |
| Should you assess lab values before tranfusion? | duh. |
| Never infuse bllod with anything but... | NS can damage RBC's with other fluids... |
| Always monitor labs after tranfusions as well and .... | DOCUMENT!!! |
| What percentage have transfusion reactions? | 2-5% |
| What are the two types of transfusion reactions? | Immunologic or non-immune |
| Immunologic is when the immune system responds to blood being infused as a foreign substance to... | attack.. |
| What are the other non-immune reactions during transfusions? | circulatory overload, sepsis, disease transmission. |
Created by:
anniemorel
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