A nurse is assessing a patient who has just received a blood transfusion.
Select all the signs or symptoms the nurse should monitor for delayed transfusion reactions.
Fever.
Increased urine output.
Jaundice.
Hypertension.
Decreased oxygen saturation.
Correct Answer : A,C
Choice A rationale:
Fever is a potential sign of a delayed transfusion reaction.
Delayed transfusion reactions can occur several days after a blood transfusion and may present with fever as a symptom.
This can be indicative of hemolysis or an immune response to the transfused blood.
Choice C rationale:
Jaundice is another sign that the nurse should monitor for delayed transfusion reactions.
Jaundice can be a result of hemolysis, where the red blood cells are destroyed, leading to an increase in bilirubin levels in the bloodstream.
Choice B rationale:
Increased urine output is not typically associated with delayed transfusion reactions.
Delayed reactions are more likely to manifest as fever, jaundice, or other signs of hemolysis.
Choice D rationale:
Hypertension is not a common sign of delayed transfusion reactions.
These reactions are more likely to present with symptoms related to the destruction of red blood cells, such as fever and jaundice.
Choice E rationale:
Decreased oxygen saturation is not a typical sign of delayed transfusion reactions.
It is important to monitor oxygen saturation during a blood transfusion, but this is more relevant to immediate transfusion reactions, such as transfusion-related acute lung injury (TRALI)
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
B- blood can be safely transfused to a client with blood type B+ since B+ individuals do not have anti-B antibodies.
However, the reverse is not true.
A client with blood type B+ should not receive B- blood because B- blood has anti-A antibodies that can react with the A antigen present on the recipient's red blood cells.
Choice B rationale:
A- blood can be safely transfused to a client with blood type B+ since B+ individuals do not have anti-A antibodies.
However, the reverse is not true.
A client with blood type B+ should not receive A- blood because A- blood has anti-B antibodies that can react with the B antigen present on the recipient's red blood cells.
Choice C rationale:
O- blood can be safely transfused to a client with blood type B+ because O- blood is universally compatible with all blood types.
O- blood does not contain A, B, or RhD antigens, making it safe for transfusion to recipients with any blood type.
Choice D rationale:
AB- blood can be safely transfused to a client with blood type B+ since B+ individuals do not have anti-A or anti-B antibodies.
However, the reverse is not true.
A client with blood type B+ should not receive AB- blood because AB- blood contains both A and B antigens, which can react with the antibodies present in the recipient's plasma.
Correct Answer is A
Explanation
Choice A rationale:
Autologous transfusion involves collecting and storing the patient's blood before a planned surgery or procedure, eliminating the risk of incompatibility, infection, and immunologic reactions associated with allogeneic (donor) blood transfusions.
This option aligns with the patient's religious beliefs and offers a safe alternative.
Choice B rationale:
Erythropoietin therapy stimulates red blood cell production but does not eliminate the need for transfusion entirely.
It may not align with the patient's refusal of blood products due to religious beliefs.
Choice C rationale:
Iron therapy can increase hemoglobin levels but may not completely eliminate the need for transfusion.
It also may not be a suitable alternative for the patient's specific condition.
Choice D rationale:
Hemostatic agents are not a substitute for blood transfusion.
They are used to control bleeding but do not address anemia or increase hemoglobin levels.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.