Med/Surg 324 Exam 1 Study Guide

MED/SURG 324 EXAM 1 STUDY GUIDE **general S/S of a transfusion reaction - answer1. Temp incr of more than 2 deg F (1 deg C) 2. Chills 3. Severe low back or chest pain 4. N/V 5. Anxiety 6. Generalized bleeding 7. Hemoglobinuria 8. Hypotension 9. Anuria 10. Dyspnea 11. Wheezing 12. Diaphoresis **What to do if you see signs of a transfusion reaction - answer1. STOP the transfusion immediately. 2. Notify the physician 3. Call the blood bank 4. save the tubing **6 different types of blood transfusion reactions - answer1. Hemolytic 2. Allergic 3. Febrile 4. Bacterial 5. Circulatory Overload 6. Transfusion-Associated Graft-Versus-Host Disease (TA-GVHD) **Pathogenesis of HEMOLYTIC transfusion reaction - answer1. Caused by blood type or Rh incompatibility 2. Blood containing antigens different from the patient's own antigens infused, antigen-antibody complexes are formed in the patient's blood 3. These complexes destroy the transfused cells and start an inflammatory response in the patient's blood vessel walls & organs 4. Reactions range form mild (fever & chills) to life threatening (DIC-aka: circulatory collapse) 5. S/S included apprehension, HA, chest pain, low back pain, tachycardia, tachypnea, hypotension, hemoglobinuria, sense of impending doom **Pathogenesis of an ALLERGIC transfusion reaction - answer1. Allergic reaction to transfused product 2. Increased risk with history of allergy 2. S/S include urticaria, itching, bronchospasm, anaphylaxis **Pathogenesis of FEBRILE transfusion reaction - answer1. More often in a patient with anti-WBC antibodies (situation that can develop after multiple transfusions) 2. S/S include chills, tachycardia, fever, hypotension **Pathogenesis of BACTERIAL transfusion reaction - answer1. Occurs as a result of contaminated blood product infusion 2. Usually a gram negative organism 3. S/S include tachycardia, hypotension, fever, chills, shock **Pathogenesis of CIRCULATORY OVERLOAD transfusion reaction - answer1. Can occur if the blood transfusion is administered too rapidly 2. Most common with whole blood transfusions or multiple transfusions 3. Older adults are at greater risk 4. S/S include HTN, bounding pulse, JVD, dyspnea, restlessness, confusion 5. Monitor I&Os, infuse blood slower, diuretics **Pathogenesis of TRANSFUSION-ASSOCIATED GRAFT-VERSUS-HOST DISEASE (TA- GVHD) - answer1. Rare but life threatening 2. Occurs in immunocompromised and immunocompetent patients 3. Manifestations occur within 1-2 weeks 4. S/S include thrombocytopenia (low platelets), anorexia, N/V, chronic hepatitis, weight loss, recurrent infection 5. 90% mortality rate but can be prevented by using irradiated blood products (destroys T-cells and cytokine products) **Autologous tranfusions - answerUses the patients own blood Preoperative autologous blood donation is the most common eliminates compatibility issues Anaphylaxis- (organs affected, treatment and immediate care of a patient experiencing this type of reaction) - answerheart, lung, kidneys? CBC includes what lab values: RBC, WBC, platelets Review normal lab values for CBC- specifically know normal for WBC, ANC, and basic electrolytes, sodium, potassium, and INR. - answerRBC count WBC count total amt Hgb in blood hematocrit - fraction of RBCs in blood average blood cell size (MCV) hemoglobin amount per red blood cell (MCH) amt of hemoglobin relative to the size of the cell (hemoglobin concentration per red blood cell (MCHC) platelet count RBC: 4.00-5.50 ml/uL Hgb: 12-16 g/dL Hct: 37-47% serum ferritin, transferrin, and total iron-binding capacity (TIBC): ?levels reticulocytes: 1.0-1.5% Platelets: 150-450 K/uL Iron (Fe)