Final answer:
The correct answer is D. Low back pain and apprehension, indicating a hemolytic transfusion reaction during the administration of packed RBCs. Hemolytic transfusion reactions are caused by antibody-mediated destruction of transfused red blood cells and can include symptoms like fever, chills, and dark urine from hemoglobinuria.
Step-by-step explanation:
The direct answer to the question of which assessment finding indicates a hemolytic transfusion reaction when a nurse is administering packed RBCs to a client is D. Low back pain and apprehension. A hemolytic transfusion reaction (HTR) is a serious and potentially fatal complication of a blood transfusion, which is caused when the recipient of the blood transfusion has antibodies that attack the donated red blood cells, leading to their destruction. This type of reaction can result from receiving blood that is not compatible with the recipient's own blood type.
Hemolytic transfusion reactions are characterized by a wide range of symptoms, with some of the most common being fever, chills, low back pain, and a feeling of unease or apprehension. Other symptoms may include dark urine, which signifies hemoglobinuria due to the breakdown of red blood cells, and a rapid drop in blood pressure leading to shock.
In the case of an acute hemolytic reaction, the patient may experience such symptoms quite rapidly, within the first 15 minutes to a few hours following the initiation of the blood transfusion. Immediate cessation of the blood transfusion and management of the reaction are critical to prevent more severe complications such as acute kidney injury or disseminated intravascular coagulation (DIC).
Therefore, when a nurse is monitoring a patient receiving blood products, it is crucial to observe for signs and symptoms of a hemolytic transfusion reaction, and in the event of any suspicion, to stop the transfusion immediately and provide appropriate medical care.