Blood Transfusion Basics Quiz
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Questions and Answers

What should be checked on the blood bag before transfusion?

  • The expiry date, leakage, bubbles, or cloudiness (correct)
  • The blood group of the recipient only
  • The recipient's hospital number only
  • The type of blood product only
  • What is the maximum duration that blood transfusion should last?

  • 5 hours
  • 3 hours
  • 4 hours (correct)
  • 2 hours
  • Which of the following is NOT a common transfusion reaction?

  • Febrile Nonhemolytic reaction
  • Circulatory overload
  • Hemolytic Reaction
  • Gastrointestinal blockage (correct)
  • What should be done during the first 15 minutes of blood transfusion?

    <p>Observe for vital signs and transfusion reactions</p> Signup and view all the answers

    What action is critical when starting an intravenous blood transfusion?

    <p>Begin with normal saline and appropriate blood tubing</p> Signup and view all the answers

    What is the primary function of erythrocytes (red blood cells)?

    <p>Exchange of oxygen and carbon dioxide</p> Signup and view all the answers

    Which blood component primarily functions in the process of hemostasis?

    <p>Platelets</p> Signup and view all the answers

    What is the approximate volume of blood in an average adult male?

    <p>5.5 L</p> Signup and view all the answers

    Which type of white blood cell primarily protects against helminthic infections?

    <p>Eosinophils</p> Signup and view all the answers

    What is the normal pH range for blood, indicating its slightly alkaline nature?

    <p>7.35 - 7.45</p> Signup and view all the answers

    What component of the lymphatic system is specifically involved in the maturation of lymphocytes?

    <p>Thymus</p> Signup and view all the answers

    Which statement correctly describes the viscosity of blood?

    <p>3-4 times more viscous than water</p> Signup and view all the answers

    Which past medical history factor is specifically linked to a reduction in vitamin B12 absorption?

    <p>Partial or total gastrectomy</p> Signup and view all the answers

    What common over-the-counter medication is known to interfere with platelet aggregation?

    <p>Aspirin</p> Signup and view all the answers

    Which of the following is NOT typically assessed in the family history regarding hematological disorders?

    <p>Family history of diabetes</p> Signup and view all the answers

    Which symptom is a neurological sign that may indicate an underlying condition according to physical assessment?

    <p>Tingling or numbness</p> Signup and view all the answers

    In a physical assessment, what finding is specifically relevant to the respiratory system?

    <p>Shortness of breath on exertion</p> Signup and view all the answers

    What should be queried to assess a patient's risk for blood exposure during a physical assessment?

    <p>Previous blood transfusions</p> Signup and view all the answers

    Which lifestyle factor is relevant in personal history to potentially impacting health?

    <p>Pattern of sexual activity</p> Signup and view all the answers

    Which of the following symptoms is indicative of a potential gastrointestinal issue during an assessment?

    <p>Blood-streaked vomit</p> Signup and view all the answers

    Which type of splenic history would be significant to inquire about in the patient's medical history?

    <p>Previous splenectomy</p> Signup and view all the answers

    Which complaint is most likely indicative of anemia?

    <p>Shiny smooth tongue</p> Signup and view all the answers

    What does a decreased platelet count indicate?

    <p>Risk of spontaneous bleeding</p> Signup and view all the answers

    Which finding would suggest altered blood clotting?

    <p>Tarry stools</p> Signup and view all the answers

    What does a high MCV indicate in a Complete Blood Count?

    <p>Vitamin B12 deficiency</p> Signup and view all the answers

    What is the purpose of measuring the Prothrombin Time (PT)?

    <p>Determining clotting factor activity</p> Signup and view all the answers

    Which symptom may suggest an infection?

    <p>Abnormal breath sounds</p> Signup and view all the answers

    Which of the following does not typically suggest anemia?

    <p>Petechiae</p> Signup and view all the answers

    What laboratory test measures the average size of individual RBCs?

    <p>MCV</p> Signup and view all the answers

    Which laboratory result is indicative of thrombocytopenia?

    <p>Decreased platelet count</p> Signup and view all the answers

    The WBC differential is primarily used to evaluate what?

    <p>Potential infections</p> Signup and view all the answers

    What is a primary purpose of explaining the procedure to the patient before a bone marrow aspiration?

    <p>Allay anxiety and enlist cooperation.</p> Signup and view all the answers

    What positioning is recommended for a patient undergoing aspiration from the posterior iliac crest?

    <p>Prone position.</p> Signup and view all the answers

    Which piece of equipment is NOT typically included in a bone marrow aspiration tray?

    <p>Endoscope.</p> Signup and view all the answers

    Why is it important to administer an analgesic before the bone marrow aspiration procedure?

    <p>To minimize pain, discomfort, and anxiety.</p> Signup and view all the answers

    What skin antiseptic is commonly used during bone marrow aspiration?

    <p>Betadine.</p> Signup and view all the answers

    What action should a nurse take to ensure the desired site is properly exposed during the procedure?

    <p>Mark the area and place the patient in the proper position.</p> Signup and view all the answers

    In a case where a patient cannot tolerate the prone position, what is an alternative position for the posterior iliac crest aspiration?

    <p>Side-lying with top knee flexed.</p> Signup and view all the answers

    Which of the following is NOT a reason for pre-procedure care in bone marrow aspiration?

    <p>To complete the procedure swiftly.</p> Signup and view all the answers

    What is the role of PPE during bone marrow aspiration?

    <p>To protect the nurse from exposure to bodily fluids.</p> Signup and view all the answers

    Which type of bone marrow aspiration utilizes a disposable punch biopsy needle?

    <p>Both marrow aspiration and biopsy.</p> Signup and view all the answers

    Study Notes

    Course Information

    • Course name: NURSN325F
    • Course description: Nursing Therapeutics in General Health Care IV
    • Topic: Nursing Management of Disturbances in Hematological Functions (Part 1)
    • Instructor: MsAmy Leung
    • Week: 1

    Learning Outcomes

    • Describe the applied anatomy and physiology of hematological nursing.
    • Identify nursing assessment and common investigations for hematological nursing and related care.
    • Describe the definition, etiology, pathophysiology, clinical features, investigations, and diagnosis of common hematological disorders and the related nursing problems and care.
    • Describe the definition, purpose, and technique of blood transfusion and bone marrow transplantation and the related nursing problems and care.
    • Develop integrative nursing care plans for clients with hematological disorders.
    • Describe the basic pharmacological concepts and clinical drug therapy modalities in daily nursing practice and the related nursing considerations for hematological disorders.

    Overview

    • Structure and functions of the hematological system.
    • Assessment.
    • Investigation.
    • Blood transfusion.
    • Splectomy.

    Blood

    • Exists in a fluid state.
    • Circulates through the heart, arteries, capillaries, and veins.
    • Serves as a link between body organs.
    • Consists of plasma and cellular components.
    • Plasma (55%): water, proteins (albumin, globulins, fibrinogen), inorganic salts, urea, dissolved gases, hormones, enzymes.
    • Cellular component (45%): erythrocytes (RBC), thrombocytes (platelets), leukocytes (WBCs).

    Blood Components

    • Derived from stem cells in bone marrow by hematopoiesis.
    • Affected by stem cells (in bone marrow) and nutrients (e.g., vitamin B12, iron).

    Characteristics of Blood

    • Color: Arterial blood is bright red (due to oxygen bound to hemoglobin); venous blood is dark red (due to lower oxygen content).
    • Viscosity: 3-4 times more viscous than water; specific gravity 1.046-1.066.
    • pH: Slightly alkaline (pH 7.35-7.45).
    • Volume: 70-75 ml of blood/kg of body weight; average male and female adults have approximately 5.5 L and 4.5 L of blood respectively.

    Functions of Blood

    • Transportation: Transports oxygen, carbon dioxide, nutrients, hormones, and metabolic waste products to kidneys and liver.
    • Protection: Transports cells and substances involved in immune reactions; clotting.
    • Regulation: Regulates fluid balance, body temperature regulation, and acid-base balance.

    Types of Blood Cells

    • Erythrocytes (RBCs):
    • Major component: hemoglobin (Hb).
    • Function: exchange of oxygen and carbon dioxide between lungs and tissues.
    • Life span: 100-120 days, then destroyed in the spleen and liver.
    • Leukocytes (WBCs):
    • Function: protection from bacteria and other foreign substances.
    • Types: neutrophils (phagocytosis), eosinophils (helminthic infections), basophils (allergic reactions), lymphocytes (B-lymphocytes produce antibodies; T-lymphocytes regulate immune response), monocytes (phagocytosis).
    • Platelets:
    • Function: form platelet plug to stop bleeding and promote thrombin production.

    Hemostasis

    • A process that repairs vascular breaks to reduce blood loss from blood vessels while maintaining blood flow.
    • Components: blood vessels, platelets, coagulation factors (I to XIII).
    • Phases: vasoconstriction/vessel spasm, formation of platelet plug, formation of fibrin clot.

    Coagulation Profiles

    • Prothrombin Time (PT): Measures the time it takes for a clot to form; helps diagnose clotting disorders, and monitor anticoagulant therapy.
    • Activated Partial Thromboplastin Time (APTT): Evaluate adequacy of factors VIII, IX, XI, XII, and monitor patients taking anticoagulants.
    • International Normalized Ratio (INR): An international sensitivity index used to determine dosages of oral anticoagulants and monitor anticoagulation therapy.

    Hematological System Assessment

    • Patients may have disruptions of the hematological, immune, and coagulation systems.
    • Important to consider past medical history, including surgeries, splenic injury/splenectomy, tendency to bleed, infectious diseases (e.g., HIV), and cancer.
    • Past medications: over-the-counter medications, vitamins, herbs, nutritional supplements, aspirin/aspirin-containing compounds, non-steroidal anti-inflammatory drugs should be considered.
    • Family history of hematological or malignant disorders, allergies, and previous blood transfusions.
    • Occupation/Exposure to substances (e.g., benzene, pesticides, ionizing radiation). Social history and lifestyle factors.
    • Key components of symptoms and physical examination findings: skin and mucous membranes (bruises, infections, drainage); neurologic symptoms; respiratory symptoms; cardiovascular, gastrointestinal, and genitourinary symptoms.

    Chief Complaints

    • Patient's chief complaints often include fatigue, frequent infections, swollen glands, bleeding tendencies, changes in blood pressure, pulse and alertness.
    • Other relevant chief complaints may include dyspnea, shiny smooth tongue, ataxia, pallor of conjunctiva, nail beds, lips, oral mucosa, hematuria, tarry stools, petechiae, bleeding sites that can indicate anemia and various issues related to blood clotting. Fever, tachycardia, abnormal breath sounds, delirium, oral lesions, erythema, swelling, or drainage of the skin are all relevant chief complaints that suggest infection.

    Laboratory Tests

    • Complete Blood Count (CBC): measures RBCs, Hb, and platelets in the blood sample.
    • WBC differential: assesses different types of WBCs to evaluate potential for infection or various types of leukemia.
    • Clotting Profile: assesses prothrombin time (PT), activated partial thromboplastin time (APTT) and INR.
    • Iron Profile: evaluates serum ferritin, iron, total iron-binding capacity, folate, and vitamin B12.
    • Blood Smear: microscopic viewing of blood, using appropriate stains, to examine cells for abnormalities.
    • Bone Marrow Aspiration (BMA) and Biopsy: analyzes bone marrow cells for various types.

    Blood Product Transfusion

    • Understand blood compatibility, antigens, antibodies and different blood types (e.g. ABO blood group system, and Rh factor or system).
    • Understand types of blood products (e.g. whole blood, packed red blood cells, platelet concentrate, fresh frozen plasma, cryoprecipitate).
    • Understand preparation, implementation, potential complications, and nursing interventions, when performing a blood transfusion.

    Splenectomy

    • Surgical removal of the spleen.
    • Reasons for surgery: trauma, hemolytic or malignant disorders, splenomegaly.
    • Laparoscopic technique.
    • Benefits of laparoscopic splenectomy: less postoperative pain, less hospitalization, quicker resumption of normal activity, and better cosmetic results.
    • Preoperative nursing care (stabilization, evacuation, monitoring, and other relevant preparations).
    • Postoperative nursing care (including monitoring for hemorrhage).
    • Possible complications (e.g., pancreatitis, fistula formation, hemorrhage, atelectasis, pneumonia).
    • Possible diagnoses and nursing interventions (e.g., ineffective breathing pattern, pain management).

    Transfusion Reactions

    • Various types of transfusion reactions possible, such as febrile nonhemolytic, hemolytic, allergic, circulatory overload, and bacterial contamination.
    • Nursing interventions during transfusion reactions, such as stopping the transfusion, notifying the doctor, changing tubing, monitoring vital signs, and other relevant actions.

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    Description

    Test your knowledge on blood transfusion practices, including the necessary checks before transfusion, common reactions, and critical actions to take during the process. This quiz covers key concepts related to blood components and their functions in the human body.

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