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Anticoagulants 
(Parenteral) 
N203 
ATI (Unit 7) 
Hematologic System -
Expected Action: Proto: Heparin — Others: enoxaparin, tinzaparin (Innohep) 
· Intrinsic factors and thrombin conversion are inhibited by heparin 
Therapeutic Uses: · Evolving stroke, PE, MI, DVT · During pregnancy 
· Adjunct during ♥ surgery, dialysis, abdominal surgery, or joint replacement 
· Disseminated intravascular coagulation 
Adverse Effects: · Hypersensitivity reaction (chills, fever, urticaria) 
· Hemorrhage 2º heparin OD (treat ĉ protamine sulfate) 
· Heparin-induced thrombocytopenia (stop if PLT < 100,000/cc) 
Contraindications/Precautions: · CI:  PLT or uncontrollable bleeding 
· CI: Surgery of eye, brain, spinal cord; regional anesthesia; lumbar puncture 
Interactions: · Anti-platelet agent  additive risk of bleeding 
· 
Education: · Monitor aPTT levels Q4-6h and then QD (60-80 sec) 
·
Treatment of Heparin OD 
N203 
ATI (Unit 7) 
Hematologic System -
Expected Action: Proto: Protamine sulfate 
· Binds with heparin and forms a non-coagulating complex 
Therapeutic Uses: · Antidote to severe heparin overdose 
· Reversal of heparin administered during procedures 
Adverse Effects: · 
· 
Contraindications/Precautions: · 
· 
Interactions: · 
· 
Education: · Administer slowly (20 mg/min or 50 mg in 10 min) 
· aPTT levels of 60-80 sec
Anticoagulant 
(Oral) 
N203 
ATI (Unit 7) 
Hematologic System -
Expected Action: Proto: warfarin (Coumadin) 
· Antagonizes vitamin K / prevents synthesis of 4 intrinsic factors & prothrombin 
Therapeutic Uses: · Prevention of venous thrombosis 
· Prevention of thrombi in A-fib and with prosthetic heart valves 
Adverse Effects: · Hemorrhage (Tx with vitamin K) 
· 
Contraindications/Precautions: · Pregnancy (X) 
· CI: Surgery of eye, brain, spinal cord; regional anesthesia; lumbar puncture 
· CI:  PLT counts, uncontrolled bleeding, vit. K δ, liver problems, alcoholism 
Interactions: · Heparin, aspirin, glucocorticoids   bleeding 
· Acetaminophen, sulfonamides, parenteral cephalosporins, ASA   [warfarin] 
· Phenobarbital, carbamazepine, phenytoin, OC, vitamin K   warfarin effects 
Education: · PT therapeutic level = 18-24 sec (normal = 11-12.5 sec) 
· Onset takes 8-12 hrs, full effect takes 3-5 days
Treatment of Warfarin OD 
N203 
ATI (Unit 7) 
Hematologic System -
Expected Action: Proto: Vitamin K (Phytonadione) 
· Promote synthesis of intrinsic factors and prothrombin 
Therapeutic Uses: · Vitamin K deficiency 
· Reversal of hypoprothrombinemia and bleeding d/t warfarin OD 
Adverse Effects: · Anaphylactoid reaction (infuse slowly in diluted solution) 
· 
Contraindications/Precautions: · 
· 
Interactions: · 
· 
Education: 
· Administer small doses (2.5 mg PO / 0.5-1 mg IV) of vitamin K to 
prevent development of resistance to warfarin. 
·
Antiplatelets 
N203 
ATI (Unit 7) 
Hematologic System -
Expected 
Action: 
Proto: Aspirin — Others: ticlopidine (Ticlid), clopidogrel (Plavix), 
dipyridamole (Persantine), abciximab (Reo Pro) 
· Prevent platelet clumping by inhibiting arterial clotting enzymes and factors 
Therapeutic Uses: · Primary prevention of acute MI · Prevention of stroke 
· Prevention of reinfarction 
· Acute coronary syndromes (abciximab and tirofiban {Aggrastat}) 
Adverse 
Effects: 
· GI effects (concurrent PPI / enteric-coated / take ĉ food) 
· Hemorrhagic stroke 
Contraindications/Precautions: · Pregnancy (D) 
Interactions: · 
· Medications that enhance bleeding  additive risk for bleeding 
Education: · 
· ASA (81 mg) for prevention / ASA (325 mg) during initial acute MI episode
Thrombolytic Medications 
N203 
ATI (Unit 7) 
Hematologic System -
Expected Action: 
Proto: streptokinase 
Others: alteplase (tPA), tenecteplase, reteplase 
· Clot dissolution by plasminogenplasmin which destroys fibrinogen 
Therapeutic Uses: · 
· Acute MI / DVT / Massive PE / Ischemic stroke (alteplase) 
Adverse Effects: · 
· Serious risk of bleeding from different sites 
Streptokinase · Hypotension (infuse slowly) 
· Allergic reaction or anaphylaxis 
Contraindications/Precautions: · Hx of intracranial hemorrhage 
· Brain tumors / pericarditis / Recent head or facial trauma / internal bleeding 
Interactions: · 
· Meds that enhance bleeding have additive risk for bleeding 
Education: · Admin within 4-6 hours of onset 
· IV aminocaproic acid for excessive fibrinolysis 
· Administer H2 antagonists such as ranitidine (Zantec) or PPI such as 
omeprazole (Prilosec) to prevent GI bleeding.
Iron Preparations 
N203 
ATI (Unit 7) 
Hematologic System -
Expected Action: Proto: Ferrous sulfate — Others: Iron Dextran 
· Increase iron level for RBC development and oxygen transport capacity 
Therapeutic Uses: · Treat and prevent iron-deficiency anemia 
Adverse Effects: · Teeth staining (liquid) {Dilute / Drink ĉ straw / Rinse} 
· GI distress: {take ĉ food if necessary but  absorption} 
· Anaphylaxis (parenteral): IV is safer / Deep IM ĉ Z-track / Infuse slowly 
Contraindications/Precautions: · 
· 
Interactions: · Vitamin C   absorption but  side effects 
· Antacids or tetracyclines   absorption 
Education: · Take on empty stomach to  absorption 
· Anticipate dark green or black stool
Vitamin B12 
(Cyanocobalamin) 
N203 
ATI (Unit 7) 
Hematologic System -
Expected Action: Proto: Vitamin B12 (cyanocobalamin) 
· Necessary to convert folate (required for DNA production) from inactive form 
Therapeutic Uses: · Treatment of B12 deficiency 
· Megaloblastic (macrocytic) anemia related to B12 deficiency 
Adverse Effects: · 
· Hypokalemia 2º  RBC production 
Contraindications/Precautions: · 
· 
Interactions: · Folic acid supplements mask signs of B12 deficiency 
· 
Education: · Intranasal spray / oral / IM / SC 
· Injections are painful; reserved for reduced ability to absorb.
Folic Acid 
N203 
ATI (Unit 7) 
Hematologic System -
Expected Action: Proto: Folic Acid 
· Folic acid is essential in DNA production & erythropoiesis (RBC, WBC, PLT) 
Therapeutic Uses: · Tx of macrocytic anemia 
· Prevention of neural tube defects in pregnancy 
Adverse Effects: · None 
· 
Contraindications/Precautions: · 
· 
Interactions: · 
· Sulfonamides, sulfasalazine, methotrexate   folate levels ĉ concurrent use 
Education: · 
·
Hematopoietic Growth Factors 
N203 
ATI (Unit 7) 
Hematologic System -
Expected Action: Proto: Epoetin alfa (Epogen, Procrit) — Others: darbepoetin alfa 
· Act on bone marrow to  RBC production 
Therapeutic Uses: · Anemia of chronic renal failure or chemotherapy 
· HIV patients taking zidovudine 
(Retrovir) 
· Anemia in patients schedule for 
elective surgery 
Adverse Effects: · Hypertension 2º  Hct 
·  risk for CV event (MI, stroke, arrest) ĉ  Hgb > 12 g/dL or > 1 g in 2 weeks 
Contraindications/Precautions: · CI: uncontrolled hypertension 
· 
Interactions: · 
· 
Education: · RBC production requires iron, folate, and vitamin B12 
· Monitor Hgb and Hct 2x per week until target range is reached
Granulocyte Colony 
Stimulating Factor 
N203 
ATI (Unit 7) 
Hematologic System -
Expected Action: Proto: filgrastim (Neupogen) — Others: pegfilgrastim (Neulasta) 
· Medications stimulate bone marrow to  production of neutrophils. 
Therapeutic Uses: ·  infection risk with neutropenia (e.g. cancer) 
Adverse Effects: · Bone pain 
· Leukocytosis:  dose / interrupt treatment if WBC > 50,000/cc, ANC > 
20,000/cc, or platelets > 500,000/cc. 
Contraindications/Precautions: · CI: Sensitive to E. coli proteins 
· 
Interactions: · 
· 
Education: · Filgrastim should not be agitated nor mixed 
· Monitor CBC 2x per week
Granulocyte Macrophage 
Colony Stimulating Factor 
N203 
ATI (Unit 7) 
Hematologic System -
Expected Action: Proto: Sargramostim (Leukine) 
·  production of WBCs in bone marrow 
Therapeutic Uses: · 
· Facilitates recovery of bone marrow after marrow transplant. 
Adverse Effects: · Diarrhea, weakness, rash, malaise, and bone pain (call) 
· Leukocytosis, thrombocytosis: Δ if WBC>50,000, ANC>20,000, PLT>500,000 
Contraindications/Precautions: · CI: Allergic to yeast products 
· Caution ĉ ♥ disease, hypoxia, peripheral edema, pleural/pericardial effusion. 
Interactions: · 
· 
Education: · Sargramostim should not be agitated nor mixed with other meds. 
·
Thrombopoietic Growth 
Factors 
N203 
ATI (Unit 7) 
Hematologic System -
Expected Action: Proto: oprelvekin (Interleukin 11, Neumega) 
· Increases production of platelets. 
Therapeutic Uses: ·  thrombocytopenia ĉ myelosuppressive chemotherapy 
Adverse Effects: · Fluid retention (peripheral edema, dyspnea on exertion) 
· Dysrhythmias · Conjunctival injection, transient blurring, and papilledema 
Contraindications/Precautions: · 
· 
Interactions: · 
· 
Education: · Treat for 21 days or until PLT  > 50,000 
·
Whole Blood 
N203 
ATI (Unit 7) 
Hematologic System -
Expected Action: · Increases circulating blood volume 
Therapeutic Uses: · Acute blood loss, extensive burns, dehydration, shock 
Adverse Effects: · Sepsis (culture, antibiotics, IV fluids, vasopressors, steroids) 
· Acute hemolytic rxn (fever, tachycardia, hypotension): VS Q5m for 15m 
· Febrile nonhemolytic rxn (most common) (fever, headache): VS Q5m for 15m 
· Anaphylaxis: VS Q5m for 15m – IM or IV epinephrine 
· Mild allergy: If respiration uncompromised, antihistamines and restart 
· Circulatory overload: Place upright / O2 and diuretics / slower rate 
Education: · Requires countersign · Assess before, during, & after 
· Assess site & patency · Use ≥19 ga, filter, Y-tubing · No Mix 
· Complete in 2-4 hours ·  Hgb 1-2 g/dL per unit
Packed RBCs 
N203 
ATI (Unit 7) 
Hematologic System -
Expected Action: ·  # of RBCs 
Therapeutic Uses: · Erythroblastosis fetalis · Hemoglobinopathies 
· Severe symptomatic anemia (Hgb<6 g/dL) · Med-induced hemolytic anemia 
Adverse Effects: · Sepsis (culture, antibiotics, IV fluids, vasopressors, steroids) 
· Acute hemolytic rxn (fever, tachycardia, hypotension): VS Q5m for 15m 
· Febrile nonhemolytic rxn (most common) (fever, headache): VS Q5m for 15m 
· Anaphylaxis: VS Q5m for 15m – IM or IV epinephrine 
· Mild allergy: If respiration uncompromised, antihistamines and restart 
Education: · Requires countersign · Assess before, during, & after 
· Assess site & patency · Use ≥19 ga, filter, Y-tubing · No Mix 
· Complete in 2-4 hours ·  Hgb 1-2 g/dL per unit
Platelet Concentrate 
N203 
ATI (Unit 7) 
Hematologic System -
Expected Action: ·  platelet count 
Therapeutic Uses: · Thrombocytopenia (< 20,000/cc) 
· Active bleeding (platelets < 80,000/cc) 
Adverse Effects: · Sepsis (culture, antibiotics, IV fluids, vasopressors, steroids) 
· Febrile nonhemolytic rxn (most common) (fever, headache): VS Q5m for 15m 
· Mild allergy: If respiration uncompromised, antihistamines and restart 
Education: · Requires countersign · Assess before, during, & after 
· Assess site & patency · Use special platelet kit (smaller filter, shorter tube
Fresh Frozen Plasma 
N203 
ATI (Unit 7) 
Hematologic System -
Expected Action: · Replaces coagulation factors 
Therapeutic Uses: · Massive hemorrhage · Extensive burns · Shock 
· Disseminated intravascular coagulation · Antithrombin III deficiency 
· Thrombotic thrombocytopenic purpura · Reverse warfarin effects 
· Replacement therapy for factors II, V, VII, IX, X, & XI 
Adverse Effects: · Sepsis (culture, antibiotics, IV fluids, vasopressors, steroids) 
· Acute hemolytic rxn (fever, tachycardia, hypotension): VS Q5m for 15m 
· Febrile nonhemolytic rxn (most common) (fever, headache): VS Q5m for 15m 
· Anaphylaxis: VS Q5m for 15m – IM or IV epinephrine 
· Mild allergy: If respiration uncompromised, antihistamines and restart 
· Circulatory overload: Place upright / O2 and diuretics / slower rate 
Education: · Requires countersign · Assess before, during, & after 
· Assess site & patency · · No Mix
Pheresed Granulocytes 
N203 
ATI (Unit 7) 
Hematologic System -
Expected Action: · Replace neutrophils / granulocytes 
Therapeutic Uses: · Neonatal sepsis · Severe neutropenia (ANC < 500) 
· Neutrophil dysfunction · Nonresponsive life-threatening infection 
Adverse Effects: · Sepsis (culture, antibiotics, IV fluids, vasopressors, steroids) 
· Acute hemolytic rxn (fever, tachycardia, hypotension): VS Q5m for 15m 
· Febrile nonhemolytic rxn (most common) (fever, headache): VS Q5m for 15m 
· Anaphylaxis: VS Q5m for 15m – IM or IV epinephrine 
· Mild allergy: If respiration uncompromised, antihistamines and restart 
· Circulatory overload: Place upright / O2 and diuretics / slower rate 
Education: · Requires countersign · Assess before, during, & after 
· Assess site & patency · · No Mix
Albumin 
N203 
ATI (Unit 7) 
Hematologic System -
Expected Action: · Expands circulating blood volume by oncotic pressure 
Therapeutic Uses: · Hypovolemia · Burns · Adult respiratory distress 
· Hypoalbuminemia · Cardiopulmonary bypass surgery 
· Hemolytic disease of the newborn 
Adverse Effects: · 
· Risk for fluid volume excess such as pulmonary edema 
Contraindications: CHF or renal insufficiency 
Education: · Must administer IV: Slowly using an infusion pump 
· Can be administered ĉ whole blood, plasma, saline, or glucose.

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Ati flash cards 07, medications affecting the blood

  • 1. Anticoagulants (Parenteral) N203 ATI (Unit 7) Hematologic System -
  • 2. Expected Action: Proto: Heparin — Others: enoxaparin, tinzaparin (Innohep) · Intrinsic factors and thrombin conversion are inhibited by heparin Therapeutic Uses: · Evolving stroke, PE, MI, DVT · During pregnancy · Adjunct during ♥ surgery, dialysis, abdominal surgery, or joint replacement · Disseminated intravascular coagulation Adverse Effects: · Hypersensitivity reaction (chills, fever, urticaria) · Hemorrhage 2º heparin OD (treat ĉ protamine sulfate) · Heparin-induced thrombocytopenia (stop if PLT < 100,000/cc) Contraindications/Precautions: · CI:  PLT or uncontrollable bleeding · CI: Surgery of eye, brain, spinal cord; regional anesthesia; lumbar puncture Interactions: · Anti-platelet agent  additive risk of bleeding · Education: · Monitor aPTT levels Q4-6h and then QD (60-80 sec) ·
  • 3. Treatment of Heparin OD N203 ATI (Unit 7) Hematologic System -
  • 4. Expected Action: Proto: Protamine sulfate · Binds with heparin and forms a non-coagulating complex Therapeutic Uses: · Antidote to severe heparin overdose · Reversal of heparin administered during procedures Adverse Effects: · · Contraindications/Precautions: · · Interactions: · · Education: · Administer slowly (20 mg/min or 50 mg in 10 min) · aPTT levels of 60-80 sec
  • 5. Anticoagulant (Oral) N203 ATI (Unit 7) Hematologic System -
  • 6. Expected Action: Proto: warfarin (Coumadin) · Antagonizes vitamin K / prevents synthesis of 4 intrinsic factors & prothrombin Therapeutic Uses: · Prevention of venous thrombosis · Prevention of thrombi in A-fib and with prosthetic heart valves Adverse Effects: · Hemorrhage (Tx with vitamin K) · Contraindications/Precautions: · Pregnancy (X) · CI: Surgery of eye, brain, spinal cord; regional anesthesia; lumbar puncture · CI:  PLT counts, uncontrolled bleeding, vit. K δ, liver problems, alcoholism Interactions: · Heparin, aspirin, glucocorticoids   bleeding · Acetaminophen, sulfonamides, parenteral cephalosporins, ASA   [warfarin] · Phenobarbital, carbamazepine, phenytoin, OC, vitamin K   warfarin effects Education: · PT therapeutic level = 18-24 sec (normal = 11-12.5 sec) · Onset takes 8-12 hrs, full effect takes 3-5 days
  • 7. Treatment of Warfarin OD N203 ATI (Unit 7) Hematologic System -
  • 8. Expected Action: Proto: Vitamin K (Phytonadione) · Promote synthesis of intrinsic factors and prothrombin Therapeutic Uses: · Vitamin K deficiency · Reversal of hypoprothrombinemia and bleeding d/t warfarin OD Adverse Effects: · Anaphylactoid reaction (infuse slowly in diluted solution) · Contraindications/Precautions: · · Interactions: · · Education: · Administer small doses (2.5 mg PO / 0.5-1 mg IV) of vitamin K to prevent development of resistance to warfarin. ·
  • 9. Antiplatelets N203 ATI (Unit 7) Hematologic System -
  • 10. Expected Action: Proto: Aspirin — Others: ticlopidine (Ticlid), clopidogrel (Plavix), dipyridamole (Persantine), abciximab (Reo Pro) · Prevent platelet clumping by inhibiting arterial clotting enzymes and factors Therapeutic Uses: · Primary prevention of acute MI · Prevention of stroke · Prevention of reinfarction · Acute coronary syndromes (abciximab and tirofiban {Aggrastat}) Adverse Effects: · GI effects (concurrent PPI / enteric-coated / take ĉ food) · Hemorrhagic stroke Contraindications/Precautions: · Pregnancy (D) Interactions: · · Medications that enhance bleeding  additive risk for bleeding Education: · · ASA (81 mg) for prevention / ASA (325 mg) during initial acute MI episode
  • 11. Thrombolytic Medications N203 ATI (Unit 7) Hematologic System -
  • 12. Expected Action: Proto: streptokinase Others: alteplase (tPA), tenecteplase, reteplase · Clot dissolution by plasminogenplasmin which destroys fibrinogen Therapeutic Uses: · · Acute MI / DVT / Massive PE / Ischemic stroke (alteplase) Adverse Effects: · · Serious risk of bleeding from different sites Streptokinase · Hypotension (infuse slowly) · Allergic reaction or anaphylaxis Contraindications/Precautions: · Hx of intracranial hemorrhage · Brain tumors / pericarditis / Recent head or facial trauma / internal bleeding Interactions: · · Meds that enhance bleeding have additive risk for bleeding Education: · Admin within 4-6 hours of onset · IV aminocaproic acid for excessive fibrinolysis · Administer H2 antagonists such as ranitidine (Zantec) or PPI such as omeprazole (Prilosec) to prevent GI bleeding.
  • 13. Iron Preparations N203 ATI (Unit 7) Hematologic System -
  • 14. Expected Action: Proto: Ferrous sulfate — Others: Iron Dextran · Increase iron level for RBC development and oxygen transport capacity Therapeutic Uses: · Treat and prevent iron-deficiency anemia Adverse Effects: · Teeth staining (liquid) {Dilute / Drink ĉ straw / Rinse} · GI distress: {take ĉ food if necessary but  absorption} · Anaphylaxis (parenteral): IV is safer / Deep IM ĉ Z-track / Infuse slowly Contraindications/Precautions: · · Interactions: · Vitamin C   absorption but  side effects · Antacids or tetracyclines   absorption Education: · Take on empty stomach to  absorption · Anticipate dark green or black stool
  • 15. Vitamin B12 (Cyanocobalamin) N203 ATI (Unit 7) Hematologic System -
  • 16. Expected Action: Proto: Vitamin B12 (cyanocobalamin) · Necessary to convert folate (required for DNA production) from inactive form Therapeutic Uses: · Treatment of B12 deficiency · Megaloblastic (macrocytic) anemia related to B12 deficiency Adverse Effects: · · Hypokalemia 2º  RBC production Contraindications/Precautions: · · Interactions: · Folic acid supplements mask signs of B12 deficiency · Education: · Intranasal spray / oral / IM / SC · Injections are painful; reserved for reduced ability to absorb.
  • 17. Folic Acid N203 ATI (Unit 7) Hematologic System -
  • 18. Expected Action: Proto: Folic Acid · Folic acid is essential in DNA production & erythropoiesis (RBC, WBC, PLT) Therapeutic Uses: · Tx of macrocytic anemia · Prevention of neural tube defects in pregnancy Adverse Effects: · None · Contraindications/Precautions: · · Interactions: · · Sulfonamides, sulfasalazine, methotrexate   folate levels ĉ concurrent use Education: · ·
  • 19. Hematopoietic Growth Factors N203 ATI (Unit 7) Hematologic System -
  • 20. Expected Action: Proto: Epoetin alfa (Epogen, Procrit) — Others: darbepoetin alfa · Act on bone marrow to  RBC production Therapeutic Uses: · Anemia of chronic renal failure or chemotherapy · HIV patients taking zidovudine (Retrovir) · Anemia in patients schedule for elective surgery Adverse Effects: · Hypertension 2º  Hct ·  risk for CV event (MI, stroke, arrest) ĉ  Hgb > 12 g/dL or > 1 g in 2 weeks Contraindications/Precautions: · CI: uncontrolled hypertension · Interactions: · · Education: · RBC production requires iron, folate, and vitamin B12 · Monitor Hgb and Hct 2x per week until target range is reached
  • 21. Granulocyte Colony Stimulating Factor N203 ATI (Unit 7) Hematologic System -
  • 22. Expected Action: Proto: filgrastim (Neupogen) — Others: pegfilgrastim (Neulasta) · Medications stimulate bone marrow to  production of neutrophils. Therapeutic Uses: ·  infection risk with neutropenia (e.g. cancer) Adverse Effects: · Bone pain · Leukocytosis:  dose / interrupt treatment if WBC > 50,000/cc, ANC > 20,000/cc, or platelets > 500,000/cc. Contraindications/Precautions: · CI: Sensitive to E. coli proteins · Interactions: · · Education: · Filgrastim should not be agitated nor mixed · Monitor CBC 2x per week
  • 23. Granulocyte Macrophage Colony Stimulating Factor N203 ATI (Unit 7) Hematologic System -
  • 24. Expected Action: Proto: Sargramostim (Leukine) ·  production of WBCs in bone marrow Therapeutic Uses: · · Facilitates recovery of bone marrow after marrow transplant. Adverse Effects: · Diarrhea, weakness, rash, malaise, and bone pain (call) · Leukocytosis, thrombocytosis: Δ if WBC>50,000, ANC>20,000, PLT>500,000 Contraindications/Precautions: · CI: Allergic to yeast products · Caution ĉ ♥ disease, hypoxia, peripheral edema, pleural/pericardial effusion. Interactions: · · Education: · Sargramostim should not be agitated nor mixed with other meds. ·
  • 25. Thrombopoietic Growth Factors N203 ATI (Unit 7) Hematologic System -
  • 26. Expected Action: Proto: oprelvekin (Interleukin 11, Neumega) · Increases production of platelets. Therapeutic Uses: ·  thrombocytopenia ĉ myelosuppressive chemotherapy Adverse Effects: · Fluid retention (peripheral edema, dyspnea on exertion) · Dysrhythmias · Conjunctival injection, transient blurring, and papilledema Contraindications/Precautions: · · Interactions: · · Education: · Treat for 21 days or until PLT  > 50,000 ·
  • 27. Whole Blood N203 ATI (Unit 7) Hematologic System -
  • 28. Expected Action: · Increases circulating blood volume Therapeutic Uses: · Acute blood loss, extensive burns, dehydration, shock Adverse Effects: · Sepsis (culture, antibiotics, IV fluids, vasopressors, steroids) · Acute hemolytic rxn (fever, tachycardia, hypotension): VS Q5m for 15m · Febrile nonhemolytic rxn (most common) (fever, headache): VS Q5m for 15m · Anaphylaxis: VS Q5m for 15m – IM or IV epinephrine · Mild allergy: If respiration uncompromised, antihistamines and restart · Circulatory overload: Place upright / O2 and diuretics / slower rate Education: · Requires countersign · Assess before, during, & after · Assess site & patency · Use ≥19 ga, filter, Y-tubing · No Mix · Complete in 2-4 hours ·  Hgb 1-2 g/dL per unit
  • 29. Packed RBCs N203 ATI (Unit 7) Hematologic System -
  • 30. Expected Action: ·  # of RBCs Therapeutic Uses: · Erythroblastosis fetalis · Hemoglobinopathies · Severe symptomatic anemia (Hgb<6 g/dL) · Med-induced hemolytic anemia Adverse Effects: · Sepsis (culture, antibiotics, IV fluids, vasopressors, steroids) · Acute hemolytic rxn (fever, tachycardia, hypotension): VS Q5m for 15m · Febrile nonhemolytic rxn (most common) (fever, headache): VS Q5m for 15m · Anaphylaxis: VS Q5m for 15m – IM or IV epinephrine · Mild allergy: If respiration uncompromised, antihistamines and restart Education: · Requires countersign · Assess before, during, & after · Assess site & patency · Use ≥19 ga, filter, Y-tubing · No Mix · Complete in 2-4 hours ·  Hgb 1-2 g/dL per unit
  • 31. Platelet Concentrate N203 ATI (Unit 7) Hematologic System -
  • 32. Expected Action: ·  platelet count Therapeutic Uses: · Thrombocytopenia (< 20,000/cc) · Active bleeding (platelets < 80,000/cc) Adverse Effects: · Sepsis (culture, antibiotics, IV fluids, vasopressors, steroids) · Febrile nonhemolytic rxn (most common) (fever, headache): VS Q5m for 15m · Mild allergy: If respiration uncompromised, antihistamines and restart Education: · Requires countersign · Assess before, during, & after · Assess site & patency · Use special platelet kit (smaller filter, shorter tube
  • 33. Fresh Frozen Plasma N203 ATI (Unit 7) Hematologic System -
  • 34. Expected Action: · Replaces coagulation factors Therapeutic Uses: · Massive hemorrhage · Extensive burns · Shock · Disseminated intravascular coagulation · Antithrombin III deficiency · Thrombotic thrombocytopenic purpura · Reverse warfarin effects · Replacement therapy for factors II, V, VII, IX, X, & XI Adverse Effects: · Sepsis (culture, antibiotics, IV fluids, vasopressors, steroids) · Acute hemolytic rxn (fever, tachycardia, hypotension): VS Q5m for 15m · Febrile nonhemolytic rxn (most common) (fever, headache): VS Q5m for 15m · Anaphylaxis: VS Q5m for 15m – IM or IV epinephrine · Mild allergy: If respiration uncompromised, antihistamines and restart · Circulatory overload: Place upright / O2 and diuretics / slower rate Education: · Requires countersign · Assess before, during, & after · Assess site & patency · · No Mix
  • 35. Pheresed Granulocytes N203 ATI (Unit 7) Hematologic System -
  • 36. Expected Action: · Replace neutrophils / granulocytes Therapeutic Uses: · Neonatal sepsis · Severe neutropenia (ANC < 500) · Neutrophil dysfunction · Nonresponsive life-threatening infection Adverse Effects: · Sepsis (culture, antibiotics, IV fluids, vasopressors, steroids) · Acute hemolytic rxn (fever, tachycardia, hypotension): VS Q5m for 15m · Febrile nonhemolytic rxn (most common) (fever, headache): VS Q5m for 15m · Anaphylaxis: VS Q5m for 15m – IM or IV epinephrine · Mild allergy: If respiration uncompromised, antihistamines and restart · Circulatory overload: Place upright / O2 and diuretics / slower rate Education: · Requires countersign · Assess before, during, & after · Assess site & patency · · No Mix
  • 37. Albumin N203 ATI (Unit 7) Hematologic System -
  • 38. Expected Action: · Expands circulating blood volume by oncotic pressure Therapeutic Uses: · Hypovolemia · Burns · Adult respiratory distress · Hypoalbuminemia · Cardiopulmonary bypass surgery · Hemolytic disease of the newborn Adverse Effects: · · Risk for fluid volume excess such as pulmonary edema Contraindications: CHF or renal insufficiency Education: · Must administer IV: Slowly using an infusion pump · Can be administered ĉ whole blood, plasma, saline, or glucose.