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.
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
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.
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