MEDICATIONS FOR THE HEMOTOLOGIC SYSTEM

What are some examples of blood and blood products ?

-whole blood

-RBC’s

-platelet concentrations

How long should it take to administer whole blood to a patient?

2 to 4 hrs

Why would a patient need whole blood cell administration?

to replace the pt volume due to

-hemorrhage

-surgery

-trauma

-burns

-shock

What reactions should you monitor for when administering whole blood to a patient?

-rapid destruction of RBC ( acute hemolytic)

-febrile

-anaphylactic

-mild allergic

-hypervolemia

-sepsis

how long does it take to administer RBC’s to a pt?

2 to 4 hrs

When might you need to administer RBC’s to a patient?

-when you want to increase red blood cells

-severe anemia

-RBC’s are breaking down too fast (hemolytic anemia)

-inherited genetic blood d/o such as sickle cell

-moms antibodies attacks babies blood (mom rh- and bby Rh+) , erythroblastosis fetalis

When administering RBC’s reactions are we monitoring for ?

-rapid destruction of RBC ( acute hemolytic)

-febrile

-anaphylactic

-mild allergic

-sepsis

How long does it take to administer platelets ?

15 to 30 minutes

Why would you need to administer platelets to a patient?

-if the patient is actively bleeding

-to help with bone marrow suppression

-increase platelet count

Thrombo = clot, cyto = cell, penia = deficiency → too few platelets ("clotting cells").

-absent marrow production causing low RBC’s

What should you monitor for when administering platelets ?

-fever

-sepsis

How long does it take to administer fresh frozen plasma ?

30 to 60 min

When would you want to administer fresh frozen plasma ?

-to replace clotting factors due to

• hemorrhage

• burns

• shock

• reverse warfarin side effects

• blood d/o that cause small blood clots through out the body ( TTP)

What reactions should you monitor for when administering fresh frozen plasma ?

-rapid destruction of RBC ( acute hemolytic)

-febrile

-anaphylactic

-mild allergic

-hypervolemia

-sepsis

how long does it take to administer Pheresed granulocytes ( donated neutrophils given to help a patient fight a severe infection)?

45 to 60 minutes

Why would you need to administer pheresed granulocytes to a patient?

-if the patient has a low neutrophil count

-neonatal sepsis ( severe infection in the bloodstream of an infant )

-neutrophil dysfunction

What should you monitor for when administering pheresed ganulocytes?

-rapid destruction of RBC ( acute hemolytic)

-febrile

-anaphylactic

-mild allergic

-hypervolemia

-sepsis

What is albumin ?

a major protein in the blood plasma

how long would it take to administer albumin ?

5% = 1 to 10ml/min

25%= 4ml/min

when would you administer albumin ?

-burns

-hypoalbuminemia

-hypovolemia

-severe nephrotic syndrome which causes protein loss and low albumin

-edema

-moms antibodies attacks babies blood (mom rh- and bby Rh+) , erythroblastosis fetalis or HDFN

What should you monitor for when administering albumin ?

hypervolemia and edema

What does the nurse need to do prior to any tranfusion ?

-obtain consent

-establish iv access

-sodium chloride primed

-assess baseline vitals

-verify pts id and name as well as blood type

-verify it by two nurses

What should the nurse due while the transfusion is occurring ?

-stay with the patient for the first 15 min slowly

-monitor for any reaction

-if no signs of a reaction complete the infusion of product within 4 hrs and monitor the pt vitals q 1-2 hrs

What interventions should be performed if an reaction occurs while the transfusion is in process?

1. stop the transfusion

2. infuse 0.9 sodium chloride

3. notify the provider

4. follow facility protocol such as send urine sample , the bag, the tube

what should the nurse do once the transfusion is completed ?

-flush tubing

-obtain vitals

-discard the product

What do hemopoietic growth factors do ?

stimulate bone marrow to synthesize specific blood cells

What are some types of hematopoietic growth medications?

epoetin alfa

filgrastim

pegfilgrastim

sargramostim

When would you use epoetin alfa ?

-to stimulate rbc production

-if the patient is anemic and has and of the related issues

• CKD

• going through chemotherapy

• pt using medications (ART) to treat HIV

what are some side effects of epoetin alfa?

HTN

What nursing interventions should the nurse perform ?

-insert medication sub q or IV

-do not agitate the vial

-monitor the pts hematocrit and hemoglobin

how do you give filgrastim ?

injection

how do you give prefilgrastim?

through iv for 2 to 4 hrs

what is the purpose of filgrastim and prefilgrastim ?

to stimulate WBC production and help with low neutrophil count due to cancer

What are some side effects of filgrastim and prefilgrastim?

bone pain and high WBC count (leukocytosis )

What are some nursing interventions to consider when using filgrastim and pegfilgrastim?

-insert medication sub q or IV

-do not agitate the vial

-monitor the pts complete blood cell count CBT

What is the use of sargramostim?

-to help stimulate platelet production

-when the immune system produces antibodies that attack and destroy platelets

What are some side effect of sargramostim?

-headache

-rash

-infection

What are some nursing interventions to consider when administering sargramostim

this is given sub q