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AII_ exam 1
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Exam of 31 pages for the course ARRT CI Exam Study Guide at ARRT CI Exam Study Guide (AII_ exam 1)
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AII: exam 1Acute Hemolytic Transfusion REaction (AHTR)? how fast does it occur? - ANS-most
serious transfusion reaction - immune mediated hemolysis occurs when recipient has
performed antibodies to infused blood products; immediate within first 15 minutes of
transfusion
Basophs contain... - ANS-heparin and histamine - released in response to allergens
Besides anemia what are some other manifestations of B12 def - ANS-can also have
nuerologic manifestations - paresthesias, impaired position sense, fall risk
Can platelets be used prophylactically? - ANS-yes - in patient with stable hematologial
disease
clinical signs of fluid volume deficit - ANS-poor skin turgor, dry mucous membranes,
orthostatic hypotension, decrease pulse pressure, decreased urine output with
increased specific gravity
Cytotoxic Rxn - ANS-IgG or IgM antibody binding to an antigen, leads to eventual cell
and tissue damage - mistaken identification of body as foreign, activates the
complement cascade
Cytotoxic T cells - ANS-(killer) lyse cells infected with virus; active in graft rejection
Early asthma response... - ANS-bronchoconstriction, mucus secretion, vascular leak
and mucosal edema
Eosinophils increase... - ANS-with alelrgic disorders and parasitic infections
greater than 60% Hct is associated w/... - ANS-spontaneous clotting
How are RBC destroyed in the body - ANS-lose elasticity as they get older and become
trapped in small blood vessels and spleen; broken down by reticuloendothelial cells
HgB is broken down and recycled - portion is made into bilirubin and iron is recycled
How are the MCV, Mchc and RDW detected - ANS-using a peripheral smear to look at
the cell morphology
,How are thrombotic disorders treated - ANS-anticoagulation
how can the incidence and severirty of transfusion reactions be reduced - ANS-reducing
the donor leukocytes in transfusion -treat fever with anti-pyretics
How do cells appear with iron deficiency anemia - ANS-microcytic and michromic
How do clotting factors exist in the plasma - ANS-they remain inactive in the body until
activated by the clotting cascade
how do lymphocytes trave - ANS-circulate only transiently and reside in the ymph tissue
How do monocutes function - ANS-migrate to tissues and then become macrophages
How do RBC appear with low iron - ANS-microcytic and microchromic - small and pale
How do RBCs appear with VB12 and Folic Acid deficiency? What deficiency is treated?
- ANS-abnormally large RBC (MCV > 100), megaloblastic and macrocytic anemia,
usually need to treat the patient for both types of deficiency
How do the Hgb and Hct relate to each other - ANS-they operate in ratio of 1 Hgb to 3
Hct
How do wheezus vary depending of severity of asthma - ANS-louder wheezes may
occur with IMPROVEMENT - because the airway is more open and more air is flowing;
no wheezes may be heard at the worst points - because of complete constriction of the
airway
How does acquired immunity develop - ANS-in response to a specific antigen - prior
exposure or immunization; creates memory and recognizes self and non-self
How does Hgb function as a base - ANS-in the venous blood it inds with H+ ions to
buffer excess avid
How does hydroxyurea fx in the body - ANS-it influences the type of hemoglobin that is
produced
How does iron flow in the body - ANS-95-100% of absorbed iron is retained in the body;
no specific mechanism for iron excretio; secreted into the bile and then reabsorbed from
the intestines; recycled in HgB
,How does serum differ from blood plamsa - ANS-serum has been allowed to clot in a
test tube and then is run through a centrifuge which removes the clotting factors
How fast should blood be transfused - ANS-should transfuse blood within 4 hoours
(consider the iimpact of additional fluid)
How is a clot broken down? - ANS-plasminogen -> plasmin -> fibrin breakdown
How is anemia classified? - ANS-based on the physiological problem - decreased
production of RBC (altered DnA synthesis resulting from deficient nutrients), increased
destruction of RBC (hemolytic), blood loss
How is mean arterial pressure calculated - ANS-SBP+2DBP/3
How is the ANC derived - ANS-add the precentages of segmented neutrophils and
bands; multiply the total precentage by total WBC count; below 1500 cells/ mm3 = big
infection risk
How is the ANC determined - ANS-(% segs + % bands) x total WBC = ANC
How much plasma is removed for washed RBC ? who should it be used for - ANS-98%;
indicated for patients with recurrent or severe allergic/febrile reactions and those at risk
for hyperkalemia ; pt with IgA deficiency or IgA antibodies should only receive washed
cells
How often should tubing be changed when giving a blood transfusion - ANS-per each
unit of blood or per hospital policy; may need blood warmer to prevent hypothermia with
massive transfusion
How should the IV be set up for blood transfusion - ANS-hang normal saline only - 3
way tubing, filter, begin slowly (10 drops/min), mpnitor closely, stay w/ pt for 15 minutes
and take vitals every 5 m
How should the nurse deliver therapeutic interventions - ANS-start and mantain
interventions with minimal risks and complications, administer meds accurately and
safely, combatting hazards of immobility, creating wound mngmt skills
How should we communicate with SBAR - ANS-situation, background, assessment,
response
, If the blood marrow stops functioning which organs presume the roll of hematopoiesis -
ANS-the liver and the spleen
IgA - ANS-present in tears, sweat, saliva and mucus
IgD - ANS-unknown
IgE - ANS-mediator of allergy; defends against parasites
IgG - ANS-most abundant; can travel across placenta
IgM - ANS-first antibody produced in response to the antigen
Inflammatory response: cellular response - ANS-leukocytes move to area, histamine
release by mast cells (early) (increase permeability for cells to access invader);
synthesis of chemical mediators; complement system, leukotrienes, prostaglandins
Inflammatory Response: Local manifestations - ANS-pallor followed by redness,
localized warmth, edema, pain (because of inflammation and stretching), loss of
function, exudate formation
Inflammatory Response: Systemic Inflammation cause and SS - ANS-fever and
endogenous pyrogens released by macrophages and neutrophils; malaise, anorexia,
increased pulse and resp rate, leukocytosis, plasma protein synthesis
inflammatory response: vascular - ANS-immediate vasoconstriction, followed by
vasodilation; increased capillary permeability
Is it possible to get too much iron - ANS-patients who require frequent blood
transfusions to tx anemia and those with hemachromatosis (genetic disorder, excess Fe
absorption and deposition in organs), will deposit yhte iron into vital organs
Ischemia: interventions for - ineffective tissue perf - ANS-assess peripheral circ, monitor
acid base and elect, ROM + ambulation, prevent prolonged pressure, pain reliefm
hydration, smoking cessation, anti-platelet drugs, elevate limb, reduced Na+, wear
venodynes to promote circ
Ischemia: interventions for impaired skin integrity - ANS-Institute and document position
change schedule q2h
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