A nursing student asks her instructor, "I don't understand this coagulation system. When we donate blood, what keeps it from clotting in the bag?" The instructor responds:
A) "Calcium gluconate is added to the bag to keep it from clotting."
B) "If the blood is used within 24 hours from retrieval, there will be no clot formation yet."
C) "The blood bank adds heparin to every bag prior to actually collecting the blood from the donor."
D) "Citrate is added to the blood bag, which prevents it from clotting."
Ans: D
Feedback:
The addition of citrate to blood stored for transfusion purposes prevents clotting by chelating ionic calcium. Calcium (factor IV) is required for coagulation to occur, and calcium is supplied by the body for the first two steps. Blood coagulation is regulated by several natural anticoagulants, such as antithrombin III and proteins C and S, which work by inactivating some of the clotting factors. Obviously, if blood not processed but used 24 hours later, it will have clotted.
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