Author Question: A patient in the emergency department complains of back pain and difficulty breathing 15 minutes ... (Read 42 times)

kfurse · **on:** Jun 25, 2018

A patient in the emergency department complains of back pain and difficulty breathing 15 minutes after a transfusion of packed red blood cells is started. The nurse's first action should be to

a. administer oxygen therapy at a high flow rate.
b. obtain a urine specimen to send to the laboratory.
c. notify the health care provider about the symptoms.
d. disconnect the transfusion and infuse normal saline.

Question 2

A postoperative patient receiving a transfusion of packed red blood cells develops chills, fever, headache, and anxiety 35 minutes after the transfusion is started. After stopping the transfusion, what action should the nurse take?

a. Draw blood for a new crossmatch.
b. Send a urine specimen to the laboratory.
c. Administer PRN acetaminophen (Tylenol).
d. Give the PRN diphenhydramine (Benadryl).

aadams68 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: D
The patient's symptoms indicate a possible acute hemolytic reaction caused by the transfusion. The first action should be to disconnect the transfusion and infuse normal saline. The other actions also are needed but are not the highest priority.

Answer to Question 2

ANS: C
The patient's clinical manifestations are consistent with a febrile, nonhemolytic transfusion reaction. The transfusion should be stopped and antipyretics administered for the fever as ordered. A urine specimen is needed if an acute hemolytic reaction is suspected. Diphenhydramine (Benadryl) is used for allergic reactions. This type of reaction does not indicate incorrect crossmatching.