The composition of blood transfused to a hemophilia patient is?

AIIMS Nagpur NO - 2018

Medical & Surgical Nursing

Easy

Appeared in: AIIMS Nagpur NO - 2018

Explanation

Hemophilia is a genetic disorder characterized by a deficiency in specific clotting factors, most commonly Factor VIII (Hemophilia A).
The primary treatment for hemophilia is replacement therapy, which involves administering the missing clotting factor to control or prevent bleeding episodes.
Cryoprecipitate is a fraction of plasma that is rich in Factor VIII, fibrinogen, and von Willebrand factor. This concentration of Factor VIII makes it the most suitable blood product among the choices for managing bleeding in a patient with Hemophilia A.

Option A: While Fresh Frozen Plasma (FFP) contains all clotting factors, including Factor VIII, they are present in a much lower concentration compared to cryoprecipitate. It would require a large volume of plasma to achieve the same therapeutic effect, increasing the risk of fluid overload.
Option B: Packed red blood cells (PRBCs) are primarily composed of erythrocytes and are used to increase the oxygen-carrying capacity of the blood. They do not contain clotting factors and are therefore ineffective for treating hemophilia.
Option D: Hemophilia is a disorder of the coagulation cascade (secondary hemostasis), not a problem with platelet number or function (primary hemostasis). Therefore, transfusing platelets would not correct the underlying clotting factor deficiency.

Visual 1: Infographic: A flowchart illustrating the fractionation of whole blood into its main components: packed red blood cells, platelets, and plasma. A sub-branch should show plasma being further processed to yield cryoprecipitate, highlighting that it concentrates specific factors like Factor VIII.
Visual 2: Table: A comparative table of blood products (PRBCs, FFP, Platelets, Cryoprecipitate) detailing their volume, primary contents, and key clinical indications.

Clinical Relevance

Nursing practice connection: Use the key finding related to Blood product therapy for hemophilia to guide bedside assessment, documentation, and the next nursing action.
Understanding the specific composition of each blood product is critical for nurses to ensure the correct component is administered to treat the patient's specific hematological deficit, preventing ineffective treatment and potential complications.
Nurses must monitor for transfusion reactions and therapeutic effectiveness. For a hemophilia patient receiving cryoprecipitate, this includes observing for cessation of bleeding and monitoring coagulation studies.
What if the patient had Hemophilia B (Factor IX deficiency)? In this scenario, cryoprecipitate would be ineffective as it does not contain Factor IX. The treatment would be Factor IX concentrate or, if unavailable, Fresh Frozen Plasma.

How to Approach the Question

First, identify the pathophysiology of the condition mentioned in the question. Hemophilia is a deficiency of clotting factors.
Next, analyze the question's core requirement. It asks for the appropriate blood 'composition' (product) to treat this deficiency.
Review the options, considering the primary function of each blood component.
Packed cells provide red blood cells for oxygen transport.
Platelets are for primary plug formation.
Plasma contains all factors but is dilute.

Concept Tested & Keywords

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