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A nurse started a transfusion of packed RBCs for a client 1 hr ago. The client has suddenly developed shaking chills, muscle stiffness, and a temperature of 38.6° C (101.5° F). The client appears flushed and reports a headache and "nervousness." The nurse should identify that the client has most likely developed which of the following types of transfusion reaction?
A nurse started a transfusion of packed RBCs for a client 1 hr ago. The client has suddenly developed shaking chills, muscle stiffness, and a temperature of 38.6° C (101.5° F). The client appears flushed and reports a headache and "nervousness." The nurse should identify that the client has most likely developed which of the following types of transfusion reaction?
A client who is anticipating total hip replacement is considering autologous transfusion. When teaching this client about autologous transfusion, it is important to emphasize that
A client who is anticipating total hip replacement is considering autologous transfusion. When teaching this client about autologous transfusion, it is important to emphasize that
A nurse is preparing a blood transfusion for a client who has type A blood. The nurse should know that the client can safely receive blood from blood group O because
A nurse is preparing a blood transfusion for a client who has type A blood. The nurse should know that the client can safely receive blood from blood group O because
A nurse is caring for a client who is receiving a blood transfusion and reports itching. The nurse observes areas of urticaria on the client's skin. Which of the following actions should the nurse take?
A nurse is caring for a client who is receiving a blood transfusion and reports itching. The nurse observes areas of urticaria on the client's skin. Which of the following actions should the nurse take?
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Which of the following actions should a nurse take prior to starting a blood transfusion?
Which of the following actions should a nurse take prior to starting a blood transfusion?
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A platelet transfusion is indicated for a patient who
A platelet transfusion is indicated for a patient who
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A nurse is providing education to a client who has a prescription for a blood transfusion. Which of the following statements should the nurse include in the teaching?
A nurse is providing education to a client who has a prescription for a blood transfusion. Which of the following statements should the nurse include in the teaching?
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A nurse is caring for a client who is about to receive a unit of packed RBCs and states, "This is my third unit of blood today. I don't want to get some disease from all this blood." Which of the following responses should the nurse make?
A nurse is caring for a client who is about to receive a unit of packed RBCs and states, "This is my third unit of blood today. I don't want to get some disease from all this blood." Which of the following responses should the nurse make?
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When administering a transfusion of packed red blood cells, it is important to
When administering a transfusion of packed red blood cells, it is important to
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A nurse is preparing to initiate the transfusion of a unit of packed RBCs to a client. After the unit of blood has arrived, which of the following procedures will help the nurse protect the client against the possibility of a blood-group incompatibility?
A nurse is preparing to initiate the transfusion of a unit of packed RBCs to a client. After the unit of blood has arrived, which of the following procedures will help the nurse protect the client against the possibility of a blood-group incompatibility?
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Study Notes
Transfusion Reactions
- The client likely developed a febrile nonhemolytic transfusion reaction due to the shaking chills, muscle stiffness, and elevated temperature.
- The client's flushed appearance, headache, and nervousness are also consistent with this type of reaction.
Autologous Transfusion
- An autologous transfusion involves using the client's own blood for a transfusion.
- This reduces the risk of complications from blood transfusions, including infections and allergic reactions.
Blood Compatibility
- Blood group O is considered the universal donor because it lacks antigens A and B on the red blood cells.
- This allows for safe transfusion to individuals with blood types A, B, AB, and O.
Transfusion Reactions
- Urticaria (hives) is a common allergic reaction to blood transfusions and can indicate an allergic transfusion reaction.
- The nurse should stop the transfusion, notify the physician, and administer antihistamines as ordered.
Pre-Transfusion Procedures
- Verify the client's identity. This commonly involves checking two patient identifiers.
- Confirm the blood product compatibility. This is a critical step in preventing incompatible blood transfusions.
- Assess the client's vital signs, which can provide baseline information.
- Explain the procedure, including the potential risks and benefits, to the client.
Platelet Transfusions
- Platelet transfusions are indicated for a patient with low platelet count (thrombocytopenia).
- This helps prevent bleeding by replacing the body's deficient platelets.
Blood Transfusion Education
- It is important to explain the risks and benefits of blood transfusions.
- Also explain the possible signs and symptoms of transfusion reactions.
- Educate the client about the importance of reporting any changes in their condition.
Blood Safety
- Blood products are carefully screened for infectious diseases.
- The risk of contracting a disease from blood transfusions is minimal.
- The blood products are tested for common bloodborne infections like HIV and hepatitis.
Administering Packed Red Blood Cells
- Administer packed red blood cells (PRBCs) slowly, usually over 2-4 hours.
- Closely monitor the client for signs of a transfusion reaction.
- Check vital signs frequently during and after the transfusion.
Preventing Blood-Group Incompatibility
- Crossmatching involves testing the recipient's blood against the donor's blood. This helps prevent incompatible blood transfusions.
- It is a crucial step in ensuring that the recipient's immune system will not attack the donor's blood.
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Description
This quiz focuses on the identification of various transfusion reactions, particularly in the context of nursing practice. Participants will analyze symptoms and scenarios to determine the likely types of reactions that can occur during blood transfusions. It is essential for nurses to recognize these reactions to ensure patient safety.
