Hematologic Function & Blood Transfusions

bone marrow

where RBCs WBCs, and platelets come from

120 days

erythrocyte lifespan

erythrocytes

transport O2 from lungs to body

10 days

lifespan for thrombocytes

coagulation

function of thrombocytes

leukocytes

multiple functions related to immunity

4,500-11,000

normal range for WBCs

detect inflammation or infection and monitor response to effects of chemotherapy/radiation

what are the uses for WBC count (part of CBC)? (2)

counts specific types of WBCs

what does a CBC w/diff do?

bacterial infection, acute stress

an increased WBC can mean… (2)

viral infection and long-term stress

what can cause a decreased WBC count? (2)

150,000-450,000

what is the normal range for platelets?

platelets

responsible for hemostasis or stopping bleeding

infections or inflammation, bone marrow disorders

what can an increase in platelets mean? (2)

bone marrow disorders, liver disease, sepsis

what can a decrease in platelets mean? (3)

4.5-5.5

what is the normal range for RBCs?

erythrocytes

carries O2 to tissues

cell death

No O2 = ___ _______

bone marrow disorders, lung or heart disease

what are causes of increased RBCs (2)

bone marrow disorders, blood loss

what can cause decreased RBCs? (2)

whole blood, platelets, RBCs, WBCs, plasma, albumin

what are all the blood components that can be given? (6)

55%

what % of blood is plasma?

plasma

mostly water; transports nutrients and hormones

BP, clotting, and immune function

plasma is important in… (3)

albumin

most common blood protein

albumin

important for fluid balance and transportation (of meds), made in the liver, tells us about nutrition status

liver

albumin is made in the _____

RBCs, plasma, WBCs, and platelets

whole blood is made up of…

500mL

how big is a unit of whole blood?

control or prevent bleeding associated with platelet deficiencies and treat thrombocytopenia

two common uses for infusing platelets

platelets

transferred more commonly than any other blood components

WBCs and Albumin

what blood components (maybe) don’t need to be ABO compatible?

fresh frozen plasma

liquid portion of blood & lymph

coagulation factor replacement (primary use), provide clotting factors, reversal of warfarin (emergent)

fresh frozen plasma is used for: (3)

2-3

normal INR numbers for someone on Warfarin?

granylocytes

type of WBC administered for low or abnormal WBC count

cancer/chemo patients

WBC’s are typically given to what kind of patient?

restore intravascular volume, maintain cardiac output in patients with hypoproteinemia

what is albumin given for? (2)

improve O2 carrying capacity and provide the same O2 carrying capacity as whole blood without additional volume

reason for giving packed red blood cells (2)

250-350mL

how big is a unit of packed red blood cells?

1g

1 unit of PRBCs raises Hgb __

3-4%

one unit of PRBCs raises Hct ___

infuse over no more than 4 hours, use blood administration tubing set, only run with 0.9% saline

what are the 3 biggest points with PRBC administration?

1. physicians order

2. patient signed informed consent

3. Type and cross

4. verification of T&C per licensed professionals

5. obtain blood and verify in lab

6. verify blood with patient and two licensed nurses

7. only use 0.9% saline with blood products

8. follow facility’s protocol for administration

What are 8 nursing considerations when giving blood products?

allergic

which transfusion reaction is this? hives, itching, anaphylaxis

febrile

which transfusion reaction is this? fever, chills, HA

hemolytic

which transfusion reaction is this? immediate onset, flushing, fever, chills, back pain, shock

transfusion-associated circulatory overload (TACO)

which transfusion reaction is this? SOB, HTN, hypoxia

stop transfusion, start new bag and tubing of NS, notify MD, follow agency protocols

what are 4 things to do if your patient has a hemolytic reaction to a transfusion?

D.

You are preparing to hang 1 unit of PRBCs. What type of IV fluid should you gather?
A. LR
B. hypotonic
C. hypertonic
D. NS

C.

Your patient comes to the urgent care complaining of fatigue and a red smooth tongue. What lab value would be important to check?
A. WBC
B. B12
C. Iron
D. platelets