Final answer:
The patient with type O- blood received two O+ blood units, which could cause an Rh incompatibility issue. A workup including an antibody screen and cross-match is crucial to prevent a possible hemolytic transfusion reaction.
Step-by-step explanation:
In the scenario described, there seems to be a potential issue with Rh incompatibility. The patient has type O-negative (O-) blood and has tested negative on the antibody screen, which suggests they do not have preformed antibodies against other blood group antigens. However, they've received two directed donor units of group O-positive (O+) blood. This could lead to a problem because the patient's immune system might recognize the Rh factor on the donor red blood cells (RBCs) as foreign and begin to produce anti-Rh antibodies, culminating in a hemolytic transfusion reaction (HTR).
This potential Rh mismatch needs immediate attention. A transfusion of Rh+ blood to an Rh- patient should be avoided unless it's an emergency and no Rh- blood is available, in which case the patient should be closely monitored for signs of an HTR. A workup for Rh incompatibility includes repeating the antibody screen and performing a cross-match to ensure compatibility of the donor units with the patient's blood. If antibodies form, they can attack the transfused Rh+ red blood cells, causing an HTR.