Fundamentals of Nursing Q 383
A client is brought to the emergency department having experienced blood loss due to a deep puncture wound. A 3 unit Fresh-frozen plasma (FFP) is ordered. The nurse determines that the reason behind this order is to:
A. Provide clotting factors and volume expansion.
B. Increase hemoglobin, hematocrit, and neutrophil levels.
C. Treat platelet dysfunction.
D. Treat thrombocytopenia.
Correct Answer: A. Provide clotting factors and volume expansion.
Fresh-frozen plasma may be used to provide clotting factors or volume expansion. It is rich in clotting factors and can be thawed quickly and transfused right away. Fresh frozen plasma is the fluid portion of a unit of whole blood frozen in a designated time frame, usually within 8 hours. FFP contains all coagulation factors except platelets.
Option B: Increasing hemoglobin, hematocrit, and neutrophil levels is not an indication for FFP. FFP corrects coagulopathy by replacing or supplying plasma proteins in patients who are deficient in or have defective plasma proteins. A standard dose of 10 to 20 mL/kg (4 to 6 units in adults) will raise factor levels by approximately 20%.
Option C: FFP does not contain platelets. Other situations where the administration of FFP cannot be recommended for or against based on systematic review include FFP transfusion at a plasma-to-RBC ratio of 1:3 or more in trauma patients with massive transfusion. Conditions that cause the deficiency of multiple coagulation factors and may require the administration of FFP include liver disease and disseminated intravascular coagulation.
Option D: Treating thrombocytopenia is incorrect since FFP does not contain any platelet. FFP contains fibrinogen (400 to 900 mg/unit), albumin, protein C, protein S, antithrombin, tissue factor pathway inhibitor. It is free of erythrocytes and leukocytes. FFP provides some volume resuscitation, as each unit contains approximately 250 ml.