Rh + or - is determined by the presence of this antigen:
D.
T or F: When D antigen is present, the person is Rh negative
False
1. This type of antigen is located on the surface of WBCs (Leukokcytes) and is also found on most cells in the body.
2. How can this antigen cause complications during transfusions?
1. HLA (Human Leukocyte Antigen)
2. Incompatible donor-recipient HLAs can lead to recipient making antibodies against the foreign HLAs.
What 4 complications can incompatible HLA between donor and recipient produce?
1. Platelet refractoriness
2. Febrile nonhemolytic reaction
3. Transfusion-related acute lung injury
4. Graft vs. host disease
Match terms of blood sources:
1. Donated by someone other than recipient
2. From friends or relatives of recipient
3. Reinfusion of recipient's own blood
a. homologous
b. autologous
c. designated
1. a
2. c
3. b
This type of autologous reinfusion of blood is when blood goes out from the body, is cleaned and filtered out, and then reintered back into the body.
Intraoperative
What are the components of whole blood?
RBC
plasma
platelets
WBC
A patient is showing signs of:
- hypotension
- dyspnea
- tachycardia
- pallor
What kind of transfusion will he need?
Whole blood: acute massive blood loss with these s/s are indications for whole blood
T or F: a unit of RBCs is prepared by removing the plasma from a whole blood unit
True
Fill in:
"Packed red cells" is when __a__ is removed, leaving behind the __b__.
a. 70-80% plasma
b. RBC and some leukocytes and platelets
Fill in: 1 unit of PRBCs should increase Hemoglobin level by __a__g/dl, and hematocrit by __b__%
a. 1g/dl
b. 3%
T or F: 1 unit of PRBCs would not give the same results of Hemoglobin and Hct with that of whole blood
False: the same results
List 4 alternatives instead of giving RBC transfusions
1. Iron
2. Vitamin B12
3. Folic Acid
4. Erythropoietin
Which type of transfusion are these indications for:
- known history of rxn caused by donor WBCs
- reduces risk of rash and anaphylactic rxns
- prevents CMV
- Immune suppressed patients
Leukocyte Reduced RBCs
What is another name for cytomegalovirus?
Herpes virus
T or F: Leukocyte reduced RBCs are 85% as efficient as original component
True
1. What are indications of irradiated blood products?
2. Which parts are irradiated?
3. What does it help prevent?
1. Used in patients with leukemia / lymphoma or immunodeficiency disorders
2. Whole blood: RBCs and platelets
3. Preents graft versus host disease by preventing donor lymphocytes from replication
What is GVHD?
When donor T-lymphocytes proliferate and attack immune compromised recipients. Can be fatal.
How long do platelets live up to in blood?
12 days
When storing platelets, they can used up to __a_ days when agitated, and __b__ when not.
a. 7 days
b. 24 hours
This transfusion type is the liquid portion of blood, which carries nutrients to tissues and helps removes wastes.
What else does it contain?
Fresh Frozen Plasma (FFP): consists mostly water that also contain protein, carbs and CLOTTING FACTORS
What is FFP called when clotting factors are removed?
Fresh Frozen Plasma is called SERUM when clotting factors are removed
Fill in: When seperating plasma from whole blood, it must be frozen within __a__ hours, and can be stored up to __b__.
a. 8 hours
b. 1 year
List 3 indicatIons for FFP
1. active bleeding with coagulation factor deficiencies
2. reversal of warfarin anti-coagulation action
3. Disseminated Intravascular coagulation (DIC)
This is prepared from FFP. It contains clotting proteins, fibrinogen in particular. It is most commonly used as part of a massive transfusion where large numbers of blood components are required to assist with clotting.
Cryoprecipitate
What are these indications for?
- source of fibrinogen
- DIC, massive hemorrhage
- Hemophilia A
- vWF disease
Cryoprecipitate
This product is a natural plasma protein extracted from whole plasma. It supplies 80% of osmotic activity of plasma to maintain osmotic pressure. What is the purpose of this osmotic pressure?
Albumin: It keeps fluid in the blood stream and not leak into tissues
When a patient has edema and is turning hypovolemic, this can be given to pull ICF back into vascular space
Albumin
T or F: Albumin transfusion does not transmit viral diseases
True: due to pasteurization
How should albumin be stored?
At room temperature in a glass bottle = vent
T or F: type and cross-mataching is required when giving albumin
False: antigens and antibodies are not present in the final product
What are 4 indications of Albumin?
1. plasma volume expander
2. Treats hypovolemic shock
3. Supports BP during hypotensive episodes
4. Induces diuresis in fluid overload
What do these s/s indicate:
- fever, tachycardia
- abd/chest/back pain
- Hypotension, dyspnea, shock
Acute Hmolytic Transfusion Reaction (AHTR)
This can occur when donor red blood cells are not compatible with patient. It is a result of an identification error during transfusion process
Acute Hemolytic Transfusion Reaction (AHTR)
List interventons for AHTR (5)
1. STOP TRANSFUSION
2. d/c tubing and start NS
3. Notify MD and lab
4. Monitor VS and maintain BP
5. Treat for shock
What are s/s of Nonhemolytic febrile reactions?
- Temp increase of 2 degrees F
- chills
- HA and vomiting
List interventions for Nonhemolytic febrile reactions (5)
1. STOP TRANSFUSION
2. d/c and start NS
3. notify md and lab
4. VS
5. administer anti-fever meds
If a patient has repeated febrile reactions, what should they receive in the future as a preventative intervention?
Leukocyte-reduced transfusions
List interventions for TRALI (transfusion-related acute lung injury) (6)
1. STOP TRANSFUSION
2. d/c tubing and start NS
3. Notify MD and lab
4. Monitor VS
5. O2 therapy (possible mechanical vent)
6. support BP
What can be done to prevent TACO (transfusion-associated circulatory overload)?
Give Lasix as ordered (to follow between 2 units)
Infuse more slowly than normal
What do these s/s indicate?
- SOB
- Cyanosis
- Tachycardia
- JVD
