Question

A patient with a history of a transfusion-related acute lung injury (TRALI) is to receive a transfusion of packed red blood cells (PRBCs). Which action by the nurse will decrease the risk for TRALI for this patient?

a. Infuse the PRBCs slowly over 4 hours.
b. Transfuse only leukocyte-reduced PRBCs.
c. Administer the scheduled diuretic before the transfusion.
d. Give the PRN dose of antihistamine before the transfusion.

Answer 1

The nurse should transfuse only leukocyte-reduced packed red blood cells (PRBCs) to decrease the risk for TRALI in a patient with a history of TRALI.

Step-by-step explanation:

Transfusion-related acute lung injury (TRALI) is a potentially life-threatening condition that can occur after a blood transfusion. To decrease the risk for TRALI in a patient with a history of TRALI, the nurse should transfuse only leukocyte-reduced packed red blood cells (PRBCs).

Option b is the correct answer. Leukocyte-reduced PRBCs have been shown to reduce the incidence of TRALI. Leukocytes in the blood can release inflammatory mediators that can contribute to the development of TRALI. By removing these leukocytes, the risk for TRALI is decreased.

Infusing the PRBCs slowly over 4 hours (option a) or administering a diuretic before the transfusion (option c) will not specifically decrease the risk for TRALI. Giving an antihistamine before the transfusion (option d) may help manage allergic reactions but will not decrease the risk for TRALI.