Examl 4:l NSGl 430/l NSG430l (Latestl 2025/l
2026l Update)l Adultl Healthl Nursingl IIl Completel Guide|l Questionsl &l Answers|l Gradel A|l 100%l Correctl (Verifiedl Solutions)-l GCU
Q:l bloodl labs
Answer:
CBC
-looksl atl thel 3l majorl cellsl inl bonel marrow:l platelets,l RBC,l wbc
PERIPHERALl SMEAR -showsl thel morphology
PANCYTOPENIA
-whenl alll typesl ofl cellsl arel suppressedl RBC -Nl rangel isl basedl onl bodyl mass
-increasedl RBC:l hemoconcentration,l polycythemial
-decreasedl RBC:l hemodilution,l hemorrhage,l anemia
-Hct:l isl thel %l ofl RBCl inl totall bloodl volume,l x3l thanl Hgb
WBC -leukemial causesl extremelyl highl levelsl (>25,000) -lessl thanl 4,000l isl leukopenia -greaterl thanl 11,000l isl infection
-differential:l showsl thel %l ofl eachl typel ofl leukocyte
-ANCl lessl thanl 1000l isl neutropenia
PLATELETS
-normall isl 150,000-400,000 -ptl atl riskl forl spontaneousl hemorrhagel ifl lessl thanl 10,000
-thrombocytosis:l riskl ofl clotting
BLOODl TYPEl ANDl RHl FACTOR -Rhl isl basedl onl thel thirdl antigen,l D -Rhl +l hasl thel Dl antigen,l Rhl -l doesl not -significantl forl bloodl transfusionl andl birth >-l moml andl +l baby->momsl needsl rhogaml tol preventl thel developmentl ofl Dl antigenl antibodiesl
-bloodl typel A:l Al antigen,l Bl antibody
-bloodl typel B:l Bl antigen,l Al antibody 1 / 4
-bloodl typel AB:l Al andl Bl antigens,l nol antibodies
-bloodl typel O:l nol antigens,l Al andl Bl antibodies
-whenl bloodl mixesl thatl hasl samel antigenl andl antibodyl thel RBCl clump,l hemolysisl willl occurl withl incompatibility
Q:l ironl metabolism
Answer:
-ironl isl obtainedl throughl dietl andl ironl supplements -itl isl foundl onl hemel asl hemoglobinl andl inl thel musclel asl myoglobin,l thel otherl 1/3l isl foundl inl thel liver,l spleen,l marrow -transferrinl isl anl ironl carrierl protein,l itsl saturationl showsl howl muchl ironl therel is -bloodl transfusionsl arel al majorl sourcel ofl iron
Q:l bloodl products
Answer:
PACKEDl RBC -anemia
PLATELETS
-thrombocytopenia FRESHl FROZENl PLASMA -forl bloodl depletedl clottingl factors -nol platelets *itl isl richl inl plateletsl butl hasl nol clottingl factors
ALBUMIN
-hypovolemial andl hypoalbuminemia
CRYOCREPITATE
-clottingl factorl VIII,l vWF,l fibrinogen
Q:l howl tol givel bloodl product
Answer:
-preparel line:l wl NSl only,l filll chamberl tol line,l IVl pumpl keepl TKOl untill ready -2l nursel checkl atl bedside -nol dextrose,l LR,l orl anythingl elsel inl line -dol VSl beforehand -havel 30l minsl tol getl bloodl running,l stopl itl beforel 4l hoursl orl theyl canl becomel septic -startl runningl atl 2l mL/minl forl firstl 15l mins,l andl stayl withl them 2 / 4
-dol VSl atl 15l mins,l ifl nol reaction,l increasel ratel -documentl inl reall time -uponl completionl dol VS -monitorl theml forl nextl 1l hrl -monitorl forl circl overloadl ifl donel tool quick *APl canl takel VS
Q:l typesl ofl reactions
Answer:
ACUTEl TRANSFUSIONl REACTIONS -mccl ofl hemolyticl reactions -typicallyl occurl withinl firstl 15l minsl ofl administration -fever,l chills,l lowl backl pain,l tachycardia,l hypotension,l hemoglobinuria,l darkl urine,l bleeding,l shock,l DIC,l death DELAYEDl TRANSFUSIONl REACTION
1.l delayedl hemolytic:
-canl occurl daysl tol monthsl after -decreasedl Hgb,l jaundice,l fever
2.l infection:l Hepl Bl andl C
3.l ironl overload:
-cirrhosis,l HF,l dysrhythmia,l diabetes,l impairedl thyroidl function
4.l graftl versusl hostl disorder:
-diarrhea,l fever,l sepsis
Q:l managingl al transfusionl reaction
Answer:
1.l stopl thel infusion 2.l keepl IVl patentl withl NS 3.l notifyl bloodl bankl andl HCP 4.l recheckl ID 5.l collectl bloodl bagl andl tubingl andl sendl tol bloodl bank 6.l treatl symptomsl perl orders 7.l takel bloodl andl urinel sample 8.l doc *thisl isl al sentinell event
Q:l autotransfusion 3 / 4
Answer:
AUTOLOGOUSl BLOODl PRODUCT -plannedl andl prel donatedl beforel al procedure -canl bel storedl frozenl forl 10l yearsl
AUTOTRANSFUSION
-donel duringl procedure -bloodl isl removed,l filtered,l andl re-infused
Q:l TACOl VSl TRALI
Answer:
TACO transfusionl associatedl circulatoryl overload -pulmonaryl edema
-s/s:l dyspnea,l hypoxemia,l increasedl RR,l hypertension,l JVD
-treatment:l O2,l intubationl andl mechanicall ventilation,l andl diuretics
-considerl MI TRALI transfusionl relatedl acutel lungl injury *thisl isl anl immunel relatedl injury -fluidl leaksl intol thel alveolarl becausel thel alveolarl capillariesl arel damagedl duel tol neutrophilsl -s/s:l SOB,l hypoxemia,l tachypnea,l fever,l hypotension,l occursl duringl orl withinl 6l hoursl ofl transfusion
-treatment:l O2,l intubationl andl mechanicall ventilation,l fluids
-considerl ARDS
DIAGNOSTICS
-BNPl <250l inl TRALI
DIFFERENCES
1.l TACO -pleurall effusions -highl BNP -nol fever -fluidsl worsen -diureticsl help 2.l TRALI -nol pleurall effusions -BNPl