ATI skills: blood administration – Flashcards
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Allogenic
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Referring to blood from a donor
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Anaplylaxis
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An immediate life threatening allergic response
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Antibody
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Type of protein the immune system produces to neutralize a threat of some kind, such as an infecting organism, a chemical, or some other foreign body
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Antigen
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Any substance capable, under appropriate conditions, of inducing a specific immune response and of triggering of an antibody specific to that substance
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Apheresis
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A process that separates donor blood into its components, removes the needed plasma or cellular elements, and returns the remainder to the donor
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Autologous
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Originating within an organism itself; applied to blood transfusion, referring to the person's own blood
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Autoimmunization
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Process by which hypersensitivity to self develops. Includes genetic factors, antigenic mimicry, Th cells recognize self as foreign, mutations, viral components, sympathetic nervous system
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Blood Component
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Any portion of a unit of blood that can be transfused to meet a patient's specific needs
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Blood Group
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Any of the classifications based on the antigens that are found on RBC's
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Blood Product
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Whole blood or any portion of a unit of blood that can be transferred to meet a patient's specific needs
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Compatability
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The absence of demonstrable immunologic reactivaty between a recipient's serum or plasma and the donor's cells; the lack of a transfusion reaction between donor and recipient
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Cryoprecipitate
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An insoluble concentrate of certain coagulation factors obtained from fresh frozen plasma
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Erthrocyte
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A blood cell whose primary function is oxygenation and carbon-dioxide transport;a RBC
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Granulocyte
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A type of WBC with granule-containing cytoplasm, such as neutrophils, eosinophils, and basophils
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Hemacrit
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The percentage of a blood sample that is RBC's
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Hempglobin
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The red, oxygen-carrying pigment of RBC's
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Leukocyte
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A WBC
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Plasma
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The liquid portion of the blood in which the particulate components are suspended (including waste products delivered to kidneys and liver)
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Platelet
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A cellular component of blood that helps with clotting
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Refractory
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Resistant to treatment; applied to blood transfusion, referring to an immunologic response developed after frequent exposure to donor cells or serum, resulting in resistance to treatment
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Serum
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The clear, liquid portion of blood that remains after coagulation has taken place
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Thrombocytopenia
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Low platelet count
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Transfusion
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The introduction of whole blood or blood components directly into the blood stream
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A platelet transfusion is indicated for a patient who:
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Has thrombocytopenia
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Prior to administering a blood transfusion, it is essential to explain to the patient that:
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He must immediately report any subjective symptoms like chills, nausea, or itching
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Which component of blood transports waste products to the kidneys and liver?
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Plasma
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A patient is about to receive a unit of packed RBC's. The unit has arrived and you are about to initiate the transfusion. Which of the following procedures will help you protect against the possibility of a blood-group incompatibility?
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Comparing the ID numbers on the blood unit with those on the order and the wristband (this ensures that all documentation of the type of blood the patient is about to receive is the correct type for the patient. Most facilities mandates that you have a second qualified person check the patient's identifiers as well)
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A patient who is anticipating total hip replacement is considering autologous transfusion. When teaching this patient about autologous transfusion, it is important to emphasize that:
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It eliminates the risk of alloimmunization
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Which is essential nursing action to starting a blood transfusion?
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Ensure informed consent has been obtained
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A patient who could benefit from a blod-product transfusion has stated on admission that she is a Jehovah's Witness. It is most likely that this patient will:
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Agree to autologous transfusion (the process of collecting, storing and re-infusing the patients own blood)
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A patient about to receive a unit packed RBC's states, "This is my third unit of blood today. I don't want to get some disease from all this blood." Which of the following would be your best response?
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Donated blood is carefully screened for infectious diseases
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You are caring for a patient with severe trauma whose blood is type A. A blood transfusion is ordered stat. You know that the patient can safely receive blood from blood group O because:
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Type O blood contains no A antigens
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When administering a transfusion of packed RBC's, it is important to:
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Make sure the entire unit is transfused within 4 hours (ideally infused w/in 2 hrs)
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A type of protein the immune system produces to neutralize a threat of some kind, such as incompatible substance in the blood is called:
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Antibody (AKA agglutinin)
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You started a transfusion of packjed RBC's about 1 hour ago. Your patient has suddenly developed shaking chills, muscle stiffness, and a temperature of 101.4 He appears flushed and reports a headache and "nervousness." Your patient has likely developed which type of transfusion reaction?
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Febrile non hemolytic (most common rxn type; fever developed 2 hr after transfusion is started)
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A nurse is preparing to flush a patient's PICC. Because the patient's catheter has a valved tip, the nurse:
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Uses non-heprinized solution for the flush Valve tipped or closed end valve catheter's incorporate a valve that opens from positive or negative pressure generated by flushing or aspirating. Otherwise, the valve remains closed to keep blood from entering the catheter. Because the blood does not back up into the catheter's lumen (where it could clot), catheters with these types of valves do not require hepranized flushes
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An older adult patient who adheres to regular cardiovascular rehabilitation schedule that includes water aerobics and swimming requires long-term central venous access. Which of the following central venous access devices is the best choice for allowing him to continue his aquatic program?
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An implanted port Because the entire device lies beneath the skin, the patient can be immersed in water when the device is not in use without any increased risk of infection. This is the best choice for patients who wish to continue aquatic activities
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A nurse is caring for a patient who has a central venous access device in place. Which of the following routine measures should the nurse use specifically to prevent lumen occlusion?
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Clamping the extension tubing while removing a syringe from the injection cap This is an example of a positive-pressure technique designed for use when a central venous access device does not have a specialized positive fluid-displacement needleless connector. This type of technique prevents the reflux of blood back into the catheter, which can clot and obstruct the catheter
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A patient who sustained trauma from a MV crash is transported to an ED. The provider determines the need for immediate central venous access for fluid and blood placement and prophylactic antibiotic therapy. The appropriate central venous access device for this patient is:
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A non-tunneled percutaneous central catheter This type of catheter is ideal for emergency situation where short-term (less than 6 weeks) central venous access is required for multiple therapies. This is the appropriate choice for this patient
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A nurse is caring for a patient who has a central venous catheter and suddenly develops dyspnea, tachycardia, and dizziness. The nurse suspects air embolism and clamps the catheter immediately. The nurse should reposition the patient in which of the following position?
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On his left side in Trendelenburg position This position helps trap the air in the apex of the right atrium rather than allowing it to enter the right ventricle and, from there, move to the pulmonary system.
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A nurse is caring for a patient who has a central venous catheter. When flushing the catheter, the nurse uses a 10-mL syringe to prevent which of the following complications with central vascular access devices?
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Catheter Rupture When injecting the fluids through a catheter, a smaller syringe generates more pressure than a larger syringe does. Therefore, to reduce the risk of catheter rupture, syringes that are 10-mL or larger in size are recommended for flushing or injecting fluid into a central venous catheter
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A nurse caring for a patient who has gastric cancer is initiating an infusion of parenteral nutrition via patient's implanted port. Which of the following is an appropriate action for the nurse to take?
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Cover the device and the needle with a sterile transplant dressing When an implanted port remains accessed for an infusion, the needle must first be supported and anchored, then the port and the needle are covered with a transparent dressing
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A nurse is preparing to obtain a blood sample from a patient who has a triple-lumen central catheter in place for multiple therapies. Which of the following is an appropriate action for the nurse to take?
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Turn of the distal infusions for 1 to 5 minutes before obtaining the blood sample. To help ensure that the laboratory results won't be altered by the solutions infusing through the central access device, it is recommended that the nurse stop the distal infusions and clamp the tubing for 1-5 minutes before obtaining the blood sample. How long to stop the infusion varies on the type of infusion
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Aging (r/t blood transfusions)
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can compromise the fx of main body systems. Cardiac & renal dysfx can increase a pt risk of congestive heart failure and fluid volume overload as a r/o blood transfusion.
