A female client with hepatitis C develops liver failure and GI hemorrhage. The blood products that would most likely bring about hemostasis in the client are:
A. Whole blood and albumin.
B. Platelets and packed red blood cells.
C. Fresh frozen plasma and whole blood.
D. Cryoprecipitate and fresh frozen plasma.
Correct Answer: D. Cryoprecipitate and fresh frozen plasma.
The liver is vital in the synthesis of clotting factors, so when it’s diseased or dysfunctional, as in hepatitis C, bleeding occurs. Treatment consists of administering blood products that aid clotting. These include fresh frozen plasma containing fibrinogen and cryoprecipitate, which have most of the clotting factors.
Option A: Although administering whole blood, albumin, and packed cells will contribute to hemostasis, those products aren’t specifically used to treat hemostasis. Whole blood is often divided into component parts for ease of storage and administration. These typically include Red Blood Cells (RBC), Platelets (thrombocytes), and Plasma.
Option B: Platelets are helpful, but the best answer is cryoprecipitate and fresh frozen plasma. Platelets are typically given when patients have a low platelet count (thrombocytopenia) or have platelets that are dysfunctional, due to medications or other acquired or inherited lesions.
Option C: The indications for whole blood and blood component transfusion consist of increasing hemoglobin and oxygenation of tissues, maintaining adequate blood volume to avoid ischemia and hypovolemic shock, and to reconstitute platelets, coagulation factors, and other plasma proteins to a functional status.
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