A nurse is monitoring a client who is receiving a blood transfusion. The nurse identifies that the client has urticaria and is wheezing. Which of the following types of transfusion reactions should the nurse suspect?
A.
Febrile
B.
Circulatory overload
C.
Acute hemolytic
D.
Anaphylactic
The correct answer and Explanation is :
The correct answer is D. Anaphylactic.
An anaphylactic reaction is a severe allergic reaction that can occur during a blood transfusion. The symptoms of anaphylaxis can appear within minutes of starting the transfusion and may include wheezing, urticaria (hives), respiratory distress, hypotension, and even shock. In this case, the client’s symptoms of urticaria and wheezing are hallmark signs of an allergic response, which can escalate into an anaphylactic reaction if not managed promptly.
Explanation:
During a blood transfusion, a client can experience different types of reactions, and it is critical for a nurse to distinguish among them to intervene appropriately.
- Febrile Reaction: This is the most common transfusion reaction. It is characterized by fever, chills, and discomfort. Febrile reactions are usually mild and occur due to the presence of antibodies reacting to donor white blood cells or other cellular components in the transfused blood. There is no wheezing or urticaria involved in this reaction.
- Circulatory Overload: This occurs when too much blood is transfused too quickly, causing hypervolemia. Symptoms include dyspnea, headache, hypertension, and pulmonary edema, but there is no allergic component such as urticaria or wheezing.
- Acute Hemolytic Reaction: This is the most severe type of reaction, often due to ABO incompatibility. Symptoms include fever, chills, back pain, hemoglobinuria, and potentially life-threatening conditions like renal failure. However, this reaction does not typically cause wheezing or urticaria.
- Anaphylactic Reaction: This reaction occurs in clients who are IgA deficient and have developed anti-IgA antibodies. Exposure to donor blood containing IgA can trigger a rapid, severe allergic response. Symptoms such as wheezing, bronchospasm, urticaria, and hypotension can progress to anaphylactic shock.
Conclusion:
Given the presence of urticaria and wheezing, the nurse should immediately suspect an anaphylactic reaction, stop the transfusion, and administer appropriate emergency interventions.