Final answer:
The first action a nurse should take if a client experiencing a transfusion reaction is to stop and disconnect the blood infusion to prevent further exposure to the possible incompatible blood. This is critical to manage a potentially life-threatening hemolytic transfusion reaction.
Step-by-step explanation:
If a client diagnosed with an aplastic sickle cell crisis reports "feeling hot" and starts to have audible wheezes within the initial 10 minutes of receiving a blood transfusion, the first action the nurse should take is to stop and disconnect the blood infusion. This is critical as the symptoms indicate a possible hemolytic transfusion reaction (HTR), which is a type II hypersensitivity cytotoxic response and can be potentially life-threatening. This immediate action is vital to prevent further exposure to the incompatible blood. Secondarily, notifying the health care provider, sending blood samples to the lab, and taking and recording vital signs are appropriate follow-up steps once the transfusion has been stopped. The patient may be experiencing signs of a blood transfusion reaction, likely due to the incompatibility of the transfused blood with the patient's own blood type.
When providing a blood transfusion, it is essential to match the ABO blood type of the donor and recipient to avoid such reactions. A patient receiving mismatched blood may show various symptoms including fever, chills, urticaria, dyspnea, and in severe cases, shock and multi-organ failure. Immediate discontinuation of the blood transfusion is the primary intervention to mitigate further complications.