Final answer:
Assessment findings for a hemolytic reaction to a blood transfusion include high fever, chills, pruritus, urticaria, severe SOB, hemoglobinuria, and hypotension. These symptoms are a result of the immune system's reaction to incompatible transfused RBCs, which can lead to severe complications, including shock and organ failure.
Step-by-step explanation:
When a patient receives a blood transfusion and has a hemolytic reaction, there are several assessment findings that may indicate this adverse event. Symptoms of a hemolytic reaction can include high fever, chills, pruritus (itching), urticaria (hives), severe shortness of breath (SOB), hemoglobinuria (hemoglobin in the urine), and hypotension (low blood pressure).
These symptoms usually occur within 1 to 24 hours after the incompatible transfusion. The reaction is due to the patient's immune system attacking the transfused red blood cells (RBCs), leading to their destruction. For example, if a Type B patient inadvertently receives Type A blood, a Type II hypersensitivity reaction ensues, with the patient's anti-A antibodies binding to the transfused RBCs and activating the complement cascade, resulting in a severe inflammatory response and hemolysis of the donor RBCs.
The debris from the lysed RBCs can occlude blood vessels, notably in the alveoli of the lungs and the glomeruli of the kidneys, leading to further complications. In the most serious reactions, shock, multi-organ failure, and possibly death can occur due to the rapid and uncontrolled destruction of red blood cells and the systemic effects of massive inflammation.