Question

A client receiving a transfusion of packed red blood cells (PRBCs) begins to vomit. The client's blood pressure is 90/50 mm Hg from a baseline of 125/78 mm Hg. The client's temperature is 100.8º F (38.2º C) orally from a baseline of 99.2º F (37.3º C) orally. The nurse determines that the client may be experiencing which complication of a blood transfusion?

a.Hemolytic reaction
b.Febrile non-hemolytic reaction
c.Anaphylactic reaction
d.Septic reaction

Answer 1

The client is likely experiencing a hemolytic reaction to the blood transfusion, marked by symptoms such as vomiting, lowered blood pressure, and increased temperature, which can lead to circulatory shock and severe complications.

Step-by-step explanation:

The client receiving a transfusion of packed red blood cells (PRBCs) who begins to vomit, with a lowered blood pressure from 125/78 mm Hg to 90/50 mm Hg, and a temperature rise from 99.2º F (37.3º C) to 100.8º F (38.2º C), may be experiencing a hemolytic reaction, which is a serious and potentially life-threatening complication of a blood transfusion.

A hemolytic reaction can occur if the client receives a transfusion with an incompatible ABO or Rh blood type. In this situation, the client's immune system mounts an attack against the transfused red blood cells (RBCs), leading to their destruction. This response is characterized by fever, chills, itching, hives, dyspnea (difficulty in breathing), hemoglobinuria (hemoglobin in the urine), and hypotension (low blood pressure), which can lead to circulatory shock and, in severe cases, multi-organ failure and death.