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Hematology
Blood
| Question | Answer |
|---|---|
| Those with type A blood can receive blood from which of the following? | A, O |
| Those with type B blood can receive blood from which of the following | B, O |
| Those with type AB blood can receive blood from which of the following | All, (A, B, AB, O) AB is the Universal Recipient |
| Those with type O blood can receive blood from which of the following | O |
| Type A blood can only donate to which blood type? | A, AB |
| Type B Blood can only donate to which blood type? | B, AB |
| Type AB blood can only donate to which blood type? | AB, ONLY |
| Type O blood can donate to which blood type? | ALL, O Is a Universal Donor |
| If a Patient, ask if receiving blood is safe the answer is: | Yes, |
| What Drug/ Medication can we give instead of Blood? | Erythropoietin (EPO) |
| What is the biggest side effect of Erythropoietin? | Hypertension |
| What is Erythropoietin: | A hormone that acts as the primary regulator of red blood cell production in the bone marrow Its produced by the kidneys and stimulates the bone marrow to increase the production of RBCs in response to tissue hypoxia (low oxygen) |
| Who will receive the freshest blood when it comes to a Big Hospital or a Little Hospital? | Little Hospitals |
| What can you offer a patient that is a Jehovah Witness that will likely to refuse a blood transfusion? | Respect their decision Offer a Bloodless Surgery Option / Autologous |
| If blood has been on a unit for 30 minutes, and has not been infused or started. What is the immediate next step? | Take it back to the Blood Bank |
| When should a patient receive platelets? | When their platelet count is 50,000 or below |
| What is Cryoprecipitate and its main use? | A blood product containing clotting factors, like (fibrinogen) Its main use is to give clotting factors back in patients with low fibrinogen. (Treatment of bleeding disorders in patients ) |
| Why is Fresh Frozen Plasma (FFP) given along with Packed Red Blood Cells (PRBCs) during severe bleeding? | To prevent severe bleeding PRBCs replace lost red cells, While FFP replaces lost clotting factors to ensure that the blood can still clot |
| IV sizes for transfusion are: | 22 - small 20- preferred 18-Big |
| What is irradiated blood and what does it prevent? | Blood treated with radiation, kills extra bacteria |
| Name two patient groups who require irradiated blood | 1. Immunocompromised patients (those on certain chemo) 2. Recipients of Directed Donations (blood from a relative) |
| What is the most important vital sign that you need to monitor while giving a blood transfusion? | Temperature, To make sure that the patient is not having a transfusion reaction |
| Once everything is ready to start the transfusion process the next step for you to do is: | Prime your Tubing |
| Why must blood tubing be primed before transfusion? | 1. To remove all air and prevent an air embolism 2. To ensure 0.9 normal saline (preventing Hemolysis) |
| What are the two most common transfusion reactions? | 1. Febrile Non-Hemolytic Transfusion Reaction 2. Allergic Reactions |
| Once you hang the blood for a transfusion, How long do you stay in the room? | 15-20 minutes |
| What is the worst reaction from a blood transfusion? | Hemolytic Reaction Means the patient received the wrong Blood. |
| What is the classic triad of symptoms for a life threatening Acute Hemolytic Transfusion Reaction? | Fever/ Chills Flank/Back Pain Hemoglobinuria (Red/Brown Urine) |
| What is the Ranges for Hemoglobin in Men and Women. | 12-16 Women 14-18 Men |
| How much blood volume does the Spleen hold? | 250-400 ml of blood |
| What is the normal range for adult leukocytes (WBCs) | 5,000-10,000 |
| What does a WBC count above the normal range (Leukocytosis) usually indicate? | The body is actively fighting infection (Bacterial or Viral) , inflammation, or stress |
| What does a WBC count below the normal range (Leukopenia) usually indicate? | Immunosuppression The body is being overwhelmed by severe infection |
| If a patient WBCs are less than 5000 the patient will be considered: | Neutropenic, high risk for infection |
| Can a patient have an infection with a low WBC count? | YES |
| What will a patient be at risk for if they have very low platelets? | Bleeding |
| What is C-Reactive Protein? | Protein made by the liver released into the bloodstream in response to "Inflammation" |
| What are some Neutropenic precautions that should be in place for a patient with a very low WBC count? | Private room, PPE should be used at all times, No fresh flowers, Limited visitors, Proper hand washing No Raw foods, No Deli meats, make sure food is cooked all the way |
| Auto immune disorders include: | RA, Lupus, Type 1 Diabetes, etc. |
| How do you stop taking steroids? | You must be tapered off, Never stop staking them abruptly |
| Signs and Symptoms of taking steroids: | Weight gain Behavioral changes High Blood Sugar Insomnia- with high doses Decrease the ability to fight infection |
| #1 Sign/Symptom of Anemia | Fatigue |
| Why would a person have Iron Deficiency? | Absorption |
| Why would a patient have an elevated SED rate? | Inflammatory response, occurring somewhere in the body |
| What is a D-Dimer? | A test that helps Diagnose: Pulmonary Embolisms Blood clots DVT. |
| What is Bence Jones Protein? | An abnormal protein found in the urine Its a significant marker for Multiple Myeloma (bone cancer) |
| What are the different sizes for bruises when you have loss of platelets? | Petechiae- Small less than 3mm Purpura- Medium 3mm-10mm Ecchymosis- known as bruising, larger than 10mm |
| S/S of Anemia include: | Fatigue Tachycardia Chest pain Enlarged spleen Red tongue Sore Mouth |
| What foods are high in Iron? | Red Meat (Beef, lamb, venison, pork, liver) Beans Spinach Oatmeal Raisins Broccoli Eggs |
| What is Pernicious Anemia? | A type of vitamin B12 deficiency anemia, that is caused by an autoimmune condition preventing the absorption of vitamin B12 |
| What is the Root Cause of Pernicious Anemia? | A protein called (IF) intrinsic factor, which is produced by the stomach lining cells produced in the ilium/ small intestine. Without this protein the body can't absorb B12 |
| What is Aplastic Anemia? | A rare condition where the Bone marrow stops producing enough new blood cells. Resulting in Pancytopenia. |
| What happens if the bone marrow stops producing and cause Aplastic Anemia? | Pancytopenia "Lack of RBCs, WBCs, and Platelets" |
| What is Pancytopenia? | Reduction in all three major types of blood cells red, white and platelets. A deficiency in all cells |
| What can Iron Do to your Bowl/ Stool? | Change in color (Black Stools) Cause Constipation |
| What is the best way to absorb Iron? | Drink Citrus (Orange Juice) |
| What is the Golden Rule for a transfusion? | If in Doubt, Cut the blood off/ Stop the infusion. Do not throw the blood away |
| What is a Severe Allergic reaction? | Anaphylaxis. Stop the infusion, give epinephrine |
| What happens if the patient is having a mild allergic reaction? | Notify the PCP for further information. Can give Acetaminophen and Benadryl |
| What should you do if the patient is having a Hemolytic Reaction? | Stop the infusion and take the line out. Do not flush the tubing. Send blood back to the blood bank to determine the cause |
| What happens if the patient has an Overload Reaction? | The patient will have signs of heart failure. Stop the infusion apply the golden Rule |
| A patient with Sickle Cell Anemia Should Avoid Certain things to prevent a Sickle Cell Crisis. This includes: | Extreme Stress Extreme exercise Dehydration Alcohol Cigarettes High altitudes due to lack of oxygen, infection |
| What is Hydroxyurea? | It's a medication that decreases sickling in patients with sickle cell anemia |
| How often do Red Blood Cells Die? | Every 120 Days |
| What is Hemoglobinuria? | A condition in which red blood cells break down (hemolysis), releasing hemoglobin into the bloodstream and urine |
| Can a person live with Aplastic Anemia? | Yes, many people can live with aplastic anemia, but left untreated severe cases can be fatal |
| What are some of the reasons a person may have Aplastic Anemia? | Autoimmune disorders Chemical Benzene Environmental Medication |
| The three main causes of anemia are related to the production, destruction, and loss of red blood cells | Decreased production: The bone marrow doesn't produce enough healthy red blood cells. Destruction: Red blood cells are destroyed faster than the bone marrow can produce new ones. "Hemolytic anemia" Red blood cells are lost from the body. |
| A nurse is administering Packed Red Blood Cells (PRBCs) to a severely bleeding patient. The primary reason for also administering Fresh Frozen Plasma (FFP) is to prevent which complication? | Dilutional Coagulopathy (This is where clotting factor is impaired leading to excessive bleeding or abnormal clotting) |
| What is a Hemolytic Reaction? | The destruction of RBCs. The recipient immune system is killing to donor's RBCs faster than the body can replace them |
| What are signs and Symptoms of a Hemolytic Reaction? | Fever and Chills Back and Chest Pain Hemoglobinuria Low BP Increased HR |
| What is a Febrile Reaction? (Non-Hemolytic) | A Recipients WBCs react with the donors WBCs, Causing the body to build antibodies |
| What are the Signs and Symptoms of a Febrile Reaction? | Increased Temperature Chills headaches Increased HR Fever |
| When preparing to administer a unit of PRBCs, what is the safest and most appropriate solution to use for priming the blood administration tubing? | 0.9% Sodium Chloride (Normal Saline) |
| A patient receiving a transfusion develops hives and itching without fever or signs of respiratory distress. Which transfusion reaction is the most likely cause? | Allergic (Urticarial) Reaction |
| What is the primary function of the hormone Erythropoietin (EPO), and where is it mainly produced in the body? | Stimulates Red Blood Cell production in the bone marrow; produced by the Kidneys. |
| The nurse notes a patient's pre-transfusion temperature was 98.6. Fifteen minutes after starting the PRBCs, the temperature is 100.8. This change is most indicative of which common reaction? | Febrile Non-Hemolytic Transfusion Reaction |
| What is the primary cellular component found in a unit of Cryoprecipitate? | Fibrinogen |
| What is Irradiated Blood? | A type of blood product that has been treated with radiation to destroy certain cells, primarily lymphocytes (white blood cells) |
| What is Anemia Production? | Bone Marrow Issue The body isn't making enough RBCs or Hemoglobin due to deficiency's Ex: Iron Deficiency |
| What is Anemia Destruction? (Hemolytic) | RBCs are destroyed faster than they are made. EX: Auto Immune Disease's |
| What is Anemia Blood loss? | To much blood is lost, reducing RBC count EX: GI Bleed, Trauma |
| What is Pancytopenia? | Low RBCs, Low WBCs, Low Platelets Meaning Everything is down |
| # 1 Rule: If you are having Doubt : | Cut it OFF! - Don't flush tubing -Don't Throw away blood, Send it back to the Bank |
| Platelets Therapeutic Ranges are: | 150,000 to 400,000 |
| If a patient has a low platelet count. What is the patient at Risk for? | Excessive and Easy Bleeding |
| When taking Iron, you should avoid taking it with: | Milk /Calcium Don't drink with milk 1 hr. before or 1 hr. after |
| What can we do to help a patient that is having a sickle cell crisis? Remember " Hop To IT" | #1 Oxygen Pain Control Rest Hydration |
| What is the Number # 1 Fluid we can give to a patient with Sickle cell in a crisis for Hydration? | 0.45 NS |
| If a patient has Hemophilia, What is the number one drug they should avoid? | Aspirin. This makes the blood clot less and increases the risk of uncontrolled or sever bleeding |
| If a patient with Hemophilia Encounters a bleed, What should you do to stop the bleed? Think of RICE | ICE IT (It helps slow or stop the flow of blood) Rest Ice Compression Elevation |
| What is Hemophilia? | A rare inherited bleeding disorder. The blood doesn't clot properly due to lack of blood-clotting proteins |
| What are the signs and symptoms of Hemophilia | Excessive and unexplained bleeding Large and Deep bruises Bleeding into Joints/ Muscles Internal Bleeding in Vital Organs |
| Treatments that may help with Hemophilia include : | The Primary goal is to replace the missing clotting factor *Replacement Factor Therapy *Prophylaxis: (infusions to prevent bleeding) *On-Demand:(infusions to treat an active bleed) * Teach Safety |
| What is Chelation? | Its the removal of Toxic metal from the body and is excreted in the urine to treat iron overload |
| Why would a patient undergo Chelation Therapy? | Primarily to remove an excessive and toxic buildup of heavy metals from their body. |
| What is Multiple Myeloma? | (A cancer of the plasma cells), a type of white blood cell found primarily in the bones |
| What is so common knowledge about Multiple Myeloma? | Extreme Bone Pain, (back, ribs, and skull) Bone Breaking is very common in patients Must stay Hydrated Primarily in African Americans, especially males |
| Signs and Symptoms of Multiple Myeloma? "CRAB" | Calcium elevation Renal (kidney) Failure Anemia Bone Lesions/ Pain |
| What is Polycythemia Vera? | A blood cancer that over produces abnormal red blood cells in the blood |
| What is the Major S/S of Polycythemia Vera? | Thrombotic Overload Patient looks Red Eye issues -Double vision from dizziness High Hemoglobin range 21 to 22 or higher Elevated BP |
| What is Disseminated Intravascular Coagulation (DIC)? | Life threatening condition that has a severe complication of underlying illnesses like (Sepsis, Major Trauma, or Cancer) Its a widespread of overactive clotting that consumes all the body's clotting factors and platelets |
| What is (ITP) Immune Thrombocytopenic Purpura? | An Autoimmune disorder where the immune system produces antibodies that attack and destroy the body's own platelets "The cause is unknown" |
| What is Leukemia? | A cancer of the blood & bone marrow |
| What is the #1 treatment for Polycythemia Vera that will save the patient's life? | Therapeutic Phlebotomy |
| What is the most common therapeutic target range for the (INR) International Normalized Ratio when a patient is taking Warfarin? | 2.0-3.0 |
| The #1 Treatment for Aplastic Anemia is | Epoetin Injection It stimulates bone marrow to produce RBCs |
Created by:
LorrenIsrael