Blood
How often can you donate blood? What are the Hgb requirements to give blood?
2 months or 56 days; Hgb needs to be AT LEAST 12.5
Increases water retention and reduces diuresis
antidiuretic hormone
Regulated by aldosterone and the kidneys. What is the normal range?
sodium (135-145)
Volume expander, blood products, raise BP, with meds, hypovolemia, normal saline is fluid of choice for fluid bolus. Dextrose, saline, ringers
isotonic: 0.9% NS, lactated ringers, D5W
Diphenhydramine may be given before transfusion to prevent it.
Allergic reaction during blood transfusion
AB+ can receive from who?
Anyone! Including RH factor.
Decreased ADH, increased urine excretion and causes fluid volume deficit.
diabetes insipidus
Tall tented t waves, widened QRS
HYPERkalemia
Cerebral edema, TPN for nutrients, low sodium, severe hypoglycemia. Plasma, albumin (volume expander), dextran
Hypertonic: 3% NS, ANYTHING added to isotonic (D5NS), TPN
Helps stimulate production of WBC. Main side effect of this is bone pain. Preferred method is sub and these are measured in units.
Filgrastim
What is the difference between febrile-non hemolytic reaction, acute hemolytic reaction?
Febrile-Non Hemolytic: Most common type. Caused by a reaction to donor white blood cells (leukocytes). It leads to fever and/or chills without hemolysis. A temperature of 100.8°F or higher, or a rise of 2°F from baseline, should be reported and evaluated. Acute-Hemolytic: LIFE THREATNING, RAPID DESTRUCTION OF RED BLOOD CELLS. Fever, chills, chest pain, dyspnea, facial flushing, hypotension, flank pain, hematuria, burning feeling at the IV site.
Increased ADH and decreased urine excretion= fluid volume excess
what is SIADH
Regulated by the GI and renal systems
Magnesium
Dehydration, high sodium, DKA
Hypotonic: 0.45% NS, 0.229% NS, 1/2 NS
Indications for platelets, PRBCs, WBCs:
PRBCs:massive hemorrhage, burns, symptomatic anemia, kidney failure. Platelets:for platelet dysfunction, thrombocytopenia. WBCs: WBC dysfunction, neutropenia, infection not responding to antimicrobials.
Nursing interventions for transfusion reactions vs. Fluid volume overload.
If it is a reaction, we’re STOPING the transfusion, following protocol, setting up new primary IV fluid (Normal Saline) and infusing at KVO; urine sample and labs. Once we complete those items, we notify the MD.
If it is fluid volume overload, we will slow down the transfusion rate. If it worsens, we stop the transfusion and call the MD.
Causes of hyper and hypo volemia
Hypovolemia (isotonic fluid loss) and has loss of water and solutes from the body. Hypervolemia (isotonic fluid gain) retains water and solutes in the same proportion.
regulated by the parathyroid hormone; a main function of this is blood coagulation
Calcium
used for Electrolyte replacement, vascular fluid loss, and burns and surgery
what is lactated ringers
Occurs with administration of hypertonic solutions into vascular space (TPN)
What is osmotic diuresis
Transfusion requirements and post transfusion nursing care
Verify provider order and informed consent, Check blood type & crossmatch, 2-nurse verification (patient + blood product), Obtain baseline vital signs, Use normal saline with blood tubing (Y-set), Start transfusion within 30 minutes of receiving blood and stay with pt for 15 mins once started. POST: Monitor vital signs and assess for reactions, Observe for delayed reactions (fever, rash, dark urine), Monitor urine output, Document patient response and completion of transfusion.
What is water intoxication? What causes it?
Hypotonic fluid excess. More water than solute inside the cell. Cell is full of fluid and the excess water can cause the cell to burst. Caused by decreased renal output, over-hydration, and hormonal (increased aldosterone or ADH)
Regulated by the kidneys. Bone and teeth formation, and is necessary for function of muscle, red blood cells, and the nervous system
what is phosphorous
Used for cellular energy
What is dextrose
U-waves and St depression
HYPOkalemia