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Kathleen Shared "Blood & Blood Products" - 22 Picmonics

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Blood & Blood Products

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
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
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
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
Transfusion Reactions
Acute Hemolytic
Febrile, Non-Hemolytic
Mild Allergic
Anaphylactic
Circulatory Overload
Sepsis Reaction
Transfusion-Related Acute Lung Injury (TRALI)
Massive Blood Transfusion
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2 mins
Disseminated Intravascular Coagulation (DIC) Assessment
Mechanism
Improper Initiation of Clotting Cascade
Signs and Symptoms
Systemic Bleeding
Petechiae, Purpura, Ecchymosis
Change in LOC
Increased PT and PTT
Cyanosis
Increased Fibrin Degradation Products (FDP)
Decreased Platelets and Fibrinogen
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2 mins
Disseminated Intravascular Coagulation (DIC) Interventions
Complications
Risk for Shock
Renal Failure
Interventions
Treat Underlying Cause
Manage Bleeding
Maintain Fluid and Hemodynamic Balance
Transfusion
Oxygenation
Heparin Drip
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2 mins
Polycythemia Vera Disease
Pathophysiology
JAK2 Mutation leading to increased red blood cells
Tyrosine Kinase
Symptoms
Erythromelalgia
Pruritus
Often After Hot Shower
Headache
Treatment
Phlebotomy
Aspirin
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1 min
Postpartum Hemorrhage
Mechanism
Uterine Atony
Lacerations
Retained Placenta
Signs and Symptoms
Bleeding
Hypotension
Boggy Uterus
Considerations
Oxytocin
Bimanual Compression of Uterus
Surgery
Blood Transfusion
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2 mins
Heparin Induced Thrombocytopenia (HIT)
Pathophysiology
5-10 Days After Heparin Exposure
Heparin-Platelet Factor 4 Complex
Autoantibodies Form Against Complex
Heparin-Platelet Factor 4-Antibody Complex Binds Platelets
Platelet Aggregation
Procoagulant Release
Symptoms
Thrombocytopenia
Diagnosis
Serotonin Release Assay (SRA)
Treatment
Stop Heparin, Start Direct Thrombin Inhibitor
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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
PT/PTT Lab Values
Prothrombin Time (PT)
10-14 seconds
Activated Partial Thromboplastin Time (PTT or aPTT)
25-35 seconds
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1 min
INR Lab Value
0.8-1.2 Normal Range
Warfarin
2.0-3.0
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1 min
Bleeding Precautions
Things to Avoid
Hard Foods
Aspirin Products
Blowing Nose Forcefully
Straining During BMs
Enemas or Rectal Suppositories
Pads and Monitor Menstruation
Guidelines to Follow
Soft-bristled Toothbrush
Electric Razor
Limit Needle Sticks
Smaller Needle Size
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3 mins
Heparin (Unfractionated)
Mechanism of Action
Suppresses Coagulation
Indications
Deep Vein Thrombosis (DVT)
Pulmonary Embolism
Side Effects
Hemorrhage
Heparin-Induced Thrombocytopenia (HIT)
Considerations
Monitor aPTT
Preferred (Safe) During Pregnancy
Antidote
Protamine Sulfate
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2 mins
Warfarin Antidotes
Antidotes
Vitamin K
Fresh Frozen Plasma
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59 secs
Venous Thromboembolism (DVT) Assessment
Mechanism
Venous Wall Inflammation caused by Thrombus
Assessment
Tenderness
Edema
Warmth
Asymmetry
Considerations
Could be Asymptomatic
Monitor for Pulmonary Embolism
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58 secs
Venous Thromboembolism (DVT) Interventions
Anticoagulants
Prevention Education
Frequent Ambulation
Leg Exercises
Compression Stockings or SCD's
Avoid Nicotine and Oral Contraceptives
Surgery
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1 min
Hemophilia
Cause/Mechanism
Genetic Mutation
Assessment
Prolonged Bleeding
Pain
Hemarthrosis
Interventions
Clotting Factor Replacement Therapy
DDAVP (Desmopressin Acetate)
Antifibrinolytic Therapy
Analgesics
Considerations
Genetic Counseling
Prevent Injury
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3 mins

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