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Questions and Answers
What is the most commonly used blood product for treating low hemoglobin and hematocrit levels?
Which blood product is specifically used to elevate platelet counts in patients at risk for bleeding?
What is the recommended administration time for Fresh Frozen Plasma (FFP)?
Which blood product is primarily used to replace factor VIII and is important for controlling bleeding in certain genetic disorders?
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What does the Rh factor indicate in blood typing?
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What occurs if a Rh-negative person is exposed to Rh-positive blood?
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Which statement about sensitization in Rh-negative pregnant females is accurate?
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What is the process of leukoreduction (LR) in blood products?
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How does albumin function when used with blood products?
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What is the primary goal of cross-matching before a blood transfusion?
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What is the primary purpose of administering antibiotics in septic patients?
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Which symptom is NOT characteristic of hyperkalemia?
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What should a nurse do if a patient has an aPTT greater than 1.5 times the reference range?
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During a blood transfusion, which reaction indicates the possibility of circulatory overload?
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What is a possible risk associated with autologous blood transfusion?
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What is the main reason O negative blood is considered the universal donor?
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Which key identifier is NOT necessary to check prior to administering blood products?
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What should a nurse do if a transfusion reaction occurs?
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What is the purpose of infusing 0.9 sodium chloride after stopping a blood transfusion due to a reaction?
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What vital sign changes might indicate a blood transfusion reaction?
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When is the first time vital signs should be taken during a blood transfusion procedure?
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What is the maximum time frame for completing a blood transfusion to prevent infection?
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Why is it essential for two licensed personnel to check the patient's blood type and compatibility?
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What is the most common symptom of a febrile nonhemolytic reaction during a transfusion?
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What should be done first if an acute hemolytic reaction is suspected during a blood transfusion?
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Which group of patients is at higher risk for developing circulatory overload during a transfusion?
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What is the primary intervention required for a patient experiencing anaphylactic reactions to a transfusion?
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What is a primary symptom of a transfusion sepsis reaction?
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If a patient has a history of allergic reactions to blood transfusions, which type of RBC should be administered?
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What symptom indicates a need to assess the blood for signs of sepsis before administering a transfusion?
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What nursing intervention should be performed if a patient shows signs of mild allergic reactions during a transfusion?
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Study Notes
Blood Products Overview
- Whole Blood is rarely used, primarily for traumatic events involving significant blood loss.
- Packed Red Blood Cells (PRBCs) are the most commonly used product for low hemoglobin levels, anemias, or post-surgery blood loss. Administered over 2-4 hours.
- Platelets are given for low platelet counts (normal range: 150,000 – 450,000/µL). They are administered over 15-20 minutes to minimize bleeding risks.
- Fresh Frozen Plasma (FFP) replaces coagulation factors and is indicated for active bleeding and certain disease states. Administered over 30-60 minutes.
- Cryoprecipitate is used to replenish clotting factors, particularly factor VIII and fibrinogen in conditions like Hemophilia A. Administered over 15-20 minutes.
- Granulocytes are rarely used and are aimed at treating severely neutropenic patients.
Rh Factor and Transfusion Compatibility
- Rh factor indicates the presence (Rh positive) or absence (Rh negative) of a specific antigen on red blood cells.
- Sensitization occurs when Rh-negative individuals are exposed to Rh-positive blood, leading to irreversible antibody production that complicates future pregnancies.
- Rhophylac is used to prevent sensitization in Rh-negative pregnant women.
Leukocyte Reduced RBC
- Leukocyte-reduced red blood cells retain the same RBC mass as whole blood but have reduced plasma and leukocyte content. This technique minimizes allergic reactions from donor white blood cells.
Albumin Use
- Albumin is not a blood product but is used alongside blood products to expand blood volume and increase blood pressure by pulling fluid into the vascular system.
- Monitor protein levels and lung sounds for signs of fluid overload.
Blood Typing and Crossmatching
- Blood typing determines blood type (A, B, AB, or O) and Rh factor. O negative is the universal donor.
- Crossmatching is performed to ensure compatibility between donor and recipient blood types, identifying any risks of transfusion reactions.
Key Identifiers for Blood Administration
- Critical identifiers to check before administering blood products include patient name, date of birth, medical record number, ABO blood group, Rh compatibility, expiration date, and blood unit ID.
Nursing Interventions for Blood Transfusion
- Obtain informed consent and assess lung function prior to transfusion.
- Vital signs should be taken 30 minutes before starting the transfusion.
- Insert an 18-20 gauge IV catheter and start an infusion of 0.9% normal saline until blood is ready.
- Blood should be infused using filtered tubing, and an RN must monitor the patient for the first 15 minutes due to risk of reactions.
Symptoms of Blood Transfusion Reactions
- Common signs include erythema, fever, hypotension, chills, headache, and tachycardia, usually occurring within the first 15 minutes post-administration.
Nursing Interventions for Transfusion Reactions
- If a reaction occurs, stop the blood transfusion immediately and take vital signs. Begin an infusion of 0.9% sodium chloride using new tubing.
- Notify the healthcare provider and follow facility protocols, including sending urine samples and blood tests for analysis.
Complications of Transfusion Reactions
- Acute Hemolytic Reaction: Symptoms include chills, fever, low back pain, and hypotension, typically occurring shortly after starting the transfusion.
- Febrile Non-Hemolytic Reaction: Characterized by sudden chills and fever, treated with acetaminophen.
- Anaphylactic Reactions: Present with anxiety, urticaria, and may necessitate CPR and epinephrine.
- Circulatory Overload: Marked by cough, dyspnea, hypertension, and tachycardia, especially in older adults.
- Sepsis: Rapid onset of chills, fever, and shock, requiring antibiotics and other supportive measures.
Autologous Blood Transfusion
- Involves patients donating their blood prior to surgery for their use, reducing transfusion reactions.
- Blood can be stored fresh for up to 40 days or frozen for up to 10 years.
NCLEX RN Questions
- Knowledge of blood products is crucial, such as recognizing the appropriate product for conditions like elevated aPTT and managing transfusion reactions.
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Description
This quiz covers essential knowledge about blood disorders and the therapies associated with them. Students will explore types of blood products, transfusion reactions, and the nursing implications for administration and interventions. Prepare to understand key concepts in managing blood component therapies.