A client who received a blood transfusion develops symptoms such as epistaxis, hematuria, and menorrhagia 7 days after the transfusion.
What complication could be responsible for these symptoms?
Transfusion-associated graft-versus-host disease (TA-GVHD)
Transfusion-related immunomodulation (TRIM)
Post-transfusion purpura.
Viral infections.
The Correct Answer is C
Choice A rationale:
Transfusion-associated graft-versus-host disease (TA-GVHD) typically presents with symptoms of fever, rash, diarrhea, and pancytopenia 1 to 6 weeks after transfusion.
It is a delayed reaction, but it does not cause epistaxis, hematuria, and menorrhagia, which are bleeding symptoms.
Therefore, it is an unlikely choice for this scenario.
Choice B rationale:
Transfusion-related immunomodulation (TRIM) is a theory that blood transfusions may affect the immune system, but it does not typically present with the specific bleeding symptoms described in the scenario.
TRIM is more concerned with the immunosuppressive effects of transfusions.
Choice C rationale:
Post-transfusion purpura is a rare condition that occurs 5 to 12 days after a transfusion.
It is characterized by sudden severe thrombocytopenia (low platelet count) and bleeding symptoms, which can include epistaxis (nosebleeds), hematuria (blood in the urine), and menorrhagia (excessive menstrual bleeding)
This aligns with the symptoms described in the scenario, making it the most likely cause.
Choice D rationale:
Viral infections can be a complication of blood transfusions, but they do not typically present with these specific bleeding symptoms within 7 days after the transfusion.
Viral infections may cause a broader range of symptoms and have a longer incubation period.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
Choice A rationale:
Normal saline is a sterile solution of sodium chloride in water, and it is a commonly used intravenous fluid to expand blood volume.
It is isotonic, meaning it has a similar osmolarity to blood, and can effectively increase circulating blood volume without adding blood cells.
Choice C rationale:
Albumin is a colloid solution often used as a volume expander.
It contains proteins that help maintain colloid osmotic pressure, which can draw fluid from interstitial spaces into the bloodstream, thereby increasing blood volume and circulation without adding blood cells.
Choice D rationale:
Hydroxyethyl starch (HES) is another colloid solution used as a volume expander.
It works similarly to albumin by increasing colloid osmotic pressure and attracting fluid into the vascular space, thereby increasing blood volume and circulation without adding blood cells.
Choice B rationale:
Erythropoietin (EPO) is a hormone that stimulates the production of red blood cells in the bone marrow.
It does not directly increase blood volume or circulation; instead, it increases the number of red blood cells, which can improve oxygen-carrying capacity in the long term but does not serve as a volume expander.
Choice E rationale:
Oxygen therapy is not a volume expander.
While it can increase the oxygen-carrying capacity of the blood by providing supplemental oxygen, it does not increase blood volume or circulation and is not used for that purpose.
Correct Answer is C
Explanation
Acute hemolytic reaction.
Choice A rationale:
A febrile nonhemolytic reaction typically presents with fever, chills, and rigors but is not associated with back pain, chest pain, dyspnea, or jaundice.
It is often caused by antibodies to leukocytes or platelets in the donor's blood.
This reaction is usually mild and self-limiting.
Choice B rationale:
Allergic reactions typically present with symptoms like urticaria, pruritus, flushing, and can include mild to moderate fever, but they do not cause back pain, chest pain, dyspnea, or jaundice.
These reactions are usually associated with sensitivity to plasma proteins or allergens in the blood product.
Choice C rationale:
Acute hemolytic reactions involve the rapid destruction of red blood cells, leading to the release of hemoglobin into the bloodstream.
This can cause fever, chills, back pain, chest pain, dyspnea, and jaundice, making it the most likely reaction in this case.
It is usually due to ABO incompatibility between the donor and recipient blood.
Choice D rationale:
Transfusion-associated circulatory overload (TACO) typically presents with symptoms related to volume overload, such as pulmonary edema, hypertension, and tachycardia.
It does not typically manifest with fever, chills, back pain, chest pain, dyspnea, or jaundice.
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