A nurse is educating a group of nursing students about blood transfusion compatibility.
Select all the blood types that can be safely transfused to a client with blood type O-.

Choice A rationale:

Lactated Ringer's solution is a volume expander, not a therapy for improving oxygen-carrying capacity.

It can increase blood volume but does not address the underlying cause of anemia or hypoxia.

Choice B rationale:

Hemostatic agents like protamine sulfate are used to reverse the anticoagulant effects of heparin.

They are not indicated for improving oxygen-carrying capacity in anemic patients.

Choice C rationale:

Oxygen therapy delivered through a nasal cannula or mask is indeed a therapy to enhance oxygen-carrying capacity.

It provides supplemental oxygen to improve oxygen saturation in the blood, which can alleviate hypoxia in anemic patients.

Choice D rationale:

Erythropoietin injections can stimulate the production of red blood cells in the bone marrow.

This therapy can increase the patient's hemoglobin levels and improve oxygen-carrying capacity, making it a suitable recommendation for a patient with hypoxia due to anemia.

For , choices A, C, and D are correct as they are examples of volume expanders that can increase blood volume and circulation without adding blood cells.

For , choice C is correct as hemostatic agents like vitamin K or tranexamic acid can promote clotting and stop bleeding in a patient with a bleeding disorder.

For , choice D is correct as erythropoietin injections can stimulate the production of red blood cells and help alleviate hypoxia in a patient with anemia.

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.