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NCLEX-RN® Test Plan: Client Needs
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Blood and Blood Products

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NCLEX-RN® Test Plan: Client Needs | Registered Nurse (RN) School Study Aid

Blood and Blood Products
12 Picmonics to Learn | 27 mins
Hemoglobin
Hemoglobin Has Four Iron Hemes
Lots Of Hemoglobin In Red Blood Cells
High O2 Levels Increase O2 Binding
High Temperature Reduces O2 Binding
High CO2 Levels Reduce O2 Binding
Low pH Reduces O2 Binding
Myoglobin Binds Oxygen in Muscle
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2 mins
Whole Blood Composition
Characteristics
Plasma
Electrolytes And Other Solutes
Proteins
Albumin
Fibrinogen
Globulins
Water
Formed Elements
Buffy Coat
White Blood Cells (WBC)
Platelets
Red Blood Cells (RBC)
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2 mins
Blood Types and Compatibilities
ABO Compatibility
No Antigens (Type O Blood)
Universal Donor
A Antigen (Type A Blood)
B Antigen (Type B Blood)
AB Antigen (Type AB Blood)
Universal Recipient
Rhesus (Rh) Compatibility
Rh (Rhesus) Antigen
Never Rh+ to Rh-
Considerations
Blood Transfusion
Obstetric Patient
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2 mins
Coagulation Cascade Overview
Secondary Hemostasis
Intrinsic Pathway
Partial Thromboplastin Time (PTT)
Heparin
Extrinsic Pathway
Prothrombin Time (PT)
Warfarin
Common Pathway
Thrombin
Convert Fibrinogen to Fibrin
Stabilizes the Platelet Plug
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2 mins
Clotting Overview
Characteristics
Endothelial Cells are Damaged
Platelets Respond to Exposed Collagen and Stick
Platelets Release Recruiting Factors
More Platelets are Attracted
Soluble Fibrinogen Turns to Insoluble Fibrin
Fibrin Seals the Clot
Clot Dissolves
Liver Produces Clotting Factors
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2 mins
Types of Blood Products
Types
Whole Blood
Packed Red Blood Cells
Fresh Frozen Plasma
Immunoglobulins
Clotting Factors
Albumin
Platelets
Considerations
Use within 24 Hours
Washing Removes Antibodies
Irradiation Destroys WBCs
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2 mins
RhoGam [Rho(D) Immune Globulin]
Indications
Antepartum Prevention at 28 weeks
Suppress Antibody Production
Mechanism of Action
Lysis of Fetal RBC in Maternal Bloodstream
Side Effects
Myalgia and Lethargy
Considerations
Negative Coombs Test
Standard Dose 300 mcg
Microdose 50 mcg
Blood Product
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2 mins
Blood Transfusion Administration
Proper Patient Identification
Large Bore Needle
Y Tubing
Baseline Vital Signs
Slow IV Infusion
Monitor During First 15 Minutes or 50 mL of Blood
Monitor for Reactions
Considerations
Do Not Add Anything To Same IV Line
No Dextrose or Lactated Ringers
Jehovah's Witnesses, No Transfusions
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3 mins
IV Solutions
Hypotonic (< 280 mOsm/L)
1/4 Normal Saline (0.225% NaCl)
1/2 Normal Saline (0.45% NaCl)
Isotonic (280-300 mOsm)
Normal Saline (0.9% NaCl)
Lactated Ringer's (LR)
Dextrose 5% in Water (D5W)
Hypertonic (> 300 mOsm)
3% or 5% NaCl
Dextrose 5% in 0.45% NaCl
Dextrose 10% in Water (D10W)
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3 mins
Types of Shock
Hypovolemic
Depleted Volume
Cardiogenic
Pump Failure
Obstructive
Indirect Pump Failure
Distributive
Lost Vascular Tone
Neurogenic
Anaphylactic
Septic
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2 mins
Informed Consent
Key Elements
Names and Qualifications of People Involved
Explanation of the Procedure
Information on Harm that Can Result
Alternative Therapies
Right to Refuse
Nurses and Consent
Nurses May Witness Consent
Student Nurses Do Not Witness Consent
Emergency
Consent from Legally Authorized Person
Life Saving Procedure Without Consent
Special Considerations
Deaf, Illiterate, Speaks a Foreign Language
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4 mins
6 Rights of Medication Administration
Right Patient
Right Medication
Right Dose
Right Time
Right Route
Right Documentation
Nursing Considerations
Three Checks
Check for Allergies
Assess the Patient
Education
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2 mins

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