A nurse is caring for a patient who received a blood transfusion 10 days ago.
The patient presents with symptoms of fever, jaundice, hemoglobinuria, and a positive Coombs test.
What complication is the patient likely experiencing?
Delayed hemolytic reaction.
Transfusion-associated graft-versus-host disease (TA-GVHD)
Post-transfusion purpura.
Transfusion-related immunomodulation (TRIM)
The Correct Answer is A
Choice A rationale:
Delayed hemolytic reactions occur several days after a blood transfusion and are characterized by symptoms like fever, jaundice, hemoglobinuria, and a positive Coombs test.
This matches the patient's presentation described in the question.
Choice B rationale:
Transfusion-associated graft-versus-host disease (TA-GVHD) typically presents with fever, rash, diarrhea, and liver dysfunction.
It is a rare but severe complication that occurs when the donor's lymphocytes attack the recipient's tissues.
Choice C rationale:
Post-transfusion purpura is a rare condition characterized by severe thrombocytopenia (low platelet count) that occurs a week or more after a blood transfusion.
It does not match the symptoms described in the question.
Choice D rationale:
Transfusion-related immunomodulation (TRIM) is a theoretical concept and not a recognized clinical entity.
It is not associated with the specific symptoms mentioned in the question.
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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 D
Explanation
Choice A rationale:
Whole blood.
Rationale: Whole blood contains red blood cells, plasma, platelets, and other components.
It is typically used for patients with significant blood loss or when multiple blood components need to be replaced.
However, in this case, the patient is specifically experiencing thrombocytopenia, which means a low platelet count.
Administering whole blood would not be the most appropriate choice because it does not provide a concentrated dose of platelets, which is what the patient needs.
Choice B rationale:
Packed red blood cells (PRBCs)
Rationale: Packed red blood cells are primarily used to increase oxygen-carrying capacity in patients with anemia or significant blood loss.
They do not contain a sufficient quantity of platelets to address thrombocytopenia, so this is not the correct choice for the patient in question.
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.
While it can be a valuable component in some cases, it does not directly increase platelet counts.
Therefore, it is not the most appropriate choice for a patient with thrombocytopenia.
Choice D rationale:
Platelets.
Rationale: Platelets are the correct choice for a patient with thrombocytopenia.
Platelet transfusion provides a concentrated dose of platelets, which can help increase the patient's platelet count and improve clotting ability.
It directly addresses the underlying issue in thrombocytopenia, making it the most suitable option.
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