The nurse is caring for a patient receiving packed red blood cells which started at 11:30 AM. The patient's vital signs and assessment findings are provided in the table below. What type of transfusion reaction will the nurse identify that the patient is experiencing?

Acute hemolytic

Allergic

Anaphylactic

Circulatory overload

Answer and Explanation

The Correct Answer is B

Choice A reason: Acute hemolytic reactions are severe and typically present with symptoms such as fever, chills, flank pain, hemoglobinuria, and shock. The patient's mild symptoms of itching and a localized rash do not match the severe presentation of an acute hemolytic reaction.

Choice B reason: Allergic reactions to blood transfusions are common and usually present with symptoms such as itching, hives, and localized rash. The patient's vital signs and physical assessment showing mild itching and a rash on the arms are consistent with an allergic reaction.

Choice C reason: Anaphylactic reactions are severe allergic reactions that involve respiratory distress, hypotension, and shock. The patient's mild symptoms do not indicate an anaphylactic reaction.

Choice D reason: Circulatory overload presents with symptoms such as dyspnea, orthopnea, hypertension, and pulmonary edema. The patient's symptoms of itching and a rash do not align with circulatory overload.

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Correct Answer is B

Explanation

Choice A reason: Chronic renal disease typically leads to metabolic acidosis, not alkalosis, due to the accumulation of acids that the kidney cannot excrete.

Choice B reason: Prolonged vomiting leads to the loss of hydrochloric acid from the stomach, which can result in metabolic alkalosis due to the imbalance caused by the loss of stomach acid.

Choice C reason: Hyperventilation leads to respiratory alkalosis due to the excessive exhalation of carbon dioxide, reducing hydrogen ion concentration in the blood.

Choice D reason: Obstructive sleep apnea is typically associated with respiratory acidosis, not metabolic alkalosis, due to episodes of hypoventilation during sleep.

A. pH 7.48, PaCO2 30, HCO3 24 B. pH 7.41, PaCO2 45, HCO3 29 C. pH 7.31, PaCO2 34, HCO3 18 D. pH 7.25, PaCO2 59, HCO3 30

Correct Answer is A

Explanation

Choice A reason: The lab results pH 7.48, PaCO2 30, HCO3 24 indicate respiratory alkalosis. Hyperventilation leads to excessive loss of carbon dioxide (PaCO2), resulting in an increase in pH (alkaline). This is consistent with pulmonary edema and hyperventilation due to heart failure.

Choice B reason: The lab results pH 7.41, PaCO2 45, HCO3 29 indicate a normal pH with compensated metabolic alkalosis. This is not consistent with hyperventilation in pulmonary edema.

Choice C reason: The lab results pH 7.31, PaCO2 34, HCO3 18 indicate metabolic acidosis with partial compensation. This is not typical for a patient with hyperventilation and pulmonary edema.

Choice D reason: The lab results pH 7.25, PaCO2 59, HCO3 30 indicate respiratory acidosis with partial compensation. This would be consistent with hypoventilation rather than hyperventilation.

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The nurse is caring for a patient receiving packed red blood cells which started at 11:30 AM. The patient's vital signs and assessment findings are provided in the table below. What type of transfusion reaction will the nurse identify that the patient is experiencing?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient with metabolic alkalosis. What will the nurse recognize as the common cause of this acid-base imbalance?

Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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