A client who received a blood transfusion 4 weeks ago now exhibits symptoms including fever, rash, diarrhea, and pancytopenia.
What complication might be responsible for these symptoms?
Delayed hemolytic reaction.
Graft-versus-host disease.
Transfusion-associated graft-versus-host disease (TA-GVHD)
Post-transfusion purpura.
The Correct Answer is C
Choice A rationale:
Delayed hemolytic reaction occurs more than 24 hours after a blood transfusion and is characterized by a drop in hemoglobin levels, jaundice, and a positive direct antiglobulin test (Coombs test)
It does not typically present with fever, rash, and pancytopenia, so it is not the best choice for the given symptoms.
Choice B rationale:
Graft-versus-host disease (GVHD) is a condition where donor T lymphocytes attack the recipient's tissues, often seen in bone marrow or stem cell transplant recipients.
While it can cause pancytopenia, it typically occurs within a few weeks of transplantation, not four weeks after a blood transfusion.
Therefore, it is less likely to be the cause in this scenario.
Choice C rationale:
Transfusion-associated graft-versus-host disease (TA-GVHD) occurs when viable T lymphocytes in the transfused blood attack the recipient's tissues.
Symptoms can include fever, rash, diarrhea, and pancytopenia.
TA-GVHD is a delayed complication of transfusion that typically presents about 1 to 6 weeks post-transfusion, making it the most likely cause of the symptoms described in the scenario.
Choice D rationale:
Post-transfusion purpura is a rare condition that occurs 5 to 12 days after a transfusion and is characterized by sudden severe thrombocytopenia (low platelet count) and bleeding, often in the form of purpura.
It does not typically present with fever, rash, and pancytopenia, so it is not the best choice for the given symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Whole blood.
Rationale: Whole blood contains all blood components, including red blood cells, plasma, platelets, and clotting factors.
It is used for patients with symptomatic anemia and ongoing bleeding, as it can address both the anemia and provide clotting factors to assist in hemostasis.
Choice B rationale:
Packed red blood cells (PRBCs)
Rationale: Packed red blood cells are primarily used to increase the oxygen-carrying capacity in patients with anemia or significant blood loss.
While they can address the anemia component of the patient's condition, they do not provide clotting factors.
Therefore, they may not be the best choice for patients with ongoing bleeding.
Choice C rationale:
Fresh frozen plasma (FFP)
Rationale: Fresh frozen plasma is rich in clotting factors and is used to treat bleeding disorders or clotting factor deficiencies.
It can be beneficial for patients with bleeding issues but does not address the anemia component of the patient's condition.
Choice D rationale:
Platelets.
Rationale: Platelets are responsible for clot formation and are primarily used to treat thrombocytopenia or clotting disorders.
They do not address the anemia component of the patient's condition and are not typically considered an alternative to blood transfusion for anemic patients with ongoing bleeding.
ABO and Rh Blood Group Systems:
Correct Answer is ["A","B","D","E"]
Explanation
Choice A rationale:
A+ blood can be safely transfused to a client with blood type O-.
The rationale is that the recipient, in this case, does not have antibodies against the A antigen, which is present on A+ blood.
Therefore, there is no antigen-antibody reaction.
Choice B rationale:
B- blood can be safely transfused to a client with blood type O-.
The rationale is similar to choice A, as the recipient does not have antibodies against the B antigen, which is present on B- blood.
Choice C rationale:
AB+ blood contains both A and B antigens and RhD antigen, which can potentially react with antibodies present in a client with blood type O-.
Therefore, it is not safe to transfuse AB+ blood to a client with blood type O-.
Choice D rationale:
O+ blood can be safely transfused to a client with blood type O-.
The rationale is that O+ blood does not have A or B antigens, which could react with antibodies present in the recipient.
Choice E rationale:
O- blood is compatible with blood type O- because it does not contain A, B, or RhD antigens, which could be targeted by antibodies in the recipient.
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