A 65-year-old patient has just received a blood transfusion. Shortly after the transfusion begins, the patient complains of chills, back pain, and difficulty breathing. What is the most likely cause of these symptoms?

Febrile non-hemolytic transfusion reaction.

Allergic reaction.

Fluid overload.

Acute hemolytic transfusion reaction.

Answer and Explanation

The Correct Answer is D

Choice A Reason:

Febrile non-hemolytic transfusion reactions (FNHTRs) are common and typically present with fever, chills, and sometimes rigors. However, they do not usually cause severe symptoms such as back pain and difficulty breathing. FNHTRs are generally less severe and are caused by the recipient’s immune response to donor white blood cells or cytokines in the transfused blood.

Choice B Reason:

Allergic reactions to blood transfusions can range from mild to severe. Mild reactions may include itching, hives, and rash, while severe reactions (anaphylaxis) can cause difficulty breathing and hypotension. However, allergic reactions do not typically cause back pain, which is more indicative of a hemolytic process.

Choice C Reason:

Fluid overload, also known as transfusion-associated circulatory overload (TACO), can occur when too much blood is transfused too quickly. Symptoms include dyspnea, hypertension, and pulmonary edema. While difficulty breathing is a symptom of fluid overload, chills and back pain are not typical features.

Choice D Reason:

Acute hemolytic transfusion reaction (AHTR) is the most likely cause of the patient’s symptoms. AHTR occurs when the recipient’s immune system attacks the transfused red blood cells, leading to their destruction. This reaction can cause severe symptoms such as chills, fever, back pain, and difficulty breathing. It is a medical emergency that requires immediate intervention to prevent serious complications, including kidney failure and shock.

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Correct Answer is A

Explanation

Choice A Reason:

Storing hearing aids in a dry, cool place when not in use is crucial for maintaining their functionality and longevity. Moisture and heat can damage the delicate electronic components of hearing aids. Using a dehumidifier specifically designed for hearing aids can help prevent moisture buildup and extend the life of the devices.

Choice B Reason:

Using cotton swabs to clean the interior components of the hearing aid is not recommended. Cotton swabs can push debris further into the hearing aid and potentially damage the internal components. Instead, specialized cleaning tools such as wax loops, brushes, and earmold tubing blowers should be used to clean hearing aids properly.

Choice C Reason:

It is not okay to wear hearing aids while showering or swimming. Most hearing aids are water-resistant but not waterproof. Exposure to water can damage the hearing aids and affect their performance. It is important to remove hearing aids before any activities involving water.

Choice D Reason:

Replacing the batteries of hearing aids once a month regardless of usage is not necessary. Battery life depends on the type of hearing aid, the battery size, and the amount of usage. It is more practical to replace the batteries when they are low or depleted, as indicated by the hearing aid’s low battery warning.

A. Administer IV levothyroxine. B. Start broad-spectrum antibiotics. C. Administer corticosteroids immediately. D. Initiate fluid restriction.

Correct Answer is A

Explanation

Choice A Reason:

Administering IV levothyroxine is the priority intervention for a patient with myxedema coma. Myxedema coma is a severe form of hypothyroidism that requires immediate thyroid hormone replacement to correct the deficiency and stabilize the patient’s condition. Intravenous levothyroxine is preferred because it provides a rapid increase in thyroid hormone levels, which is crucial for reversing the life-threatening symptoms of myxedema coma, such as hypothermia, bradycardia, and altered mental status.

Choice B Reason:

Starting broad-spectrum antibiotics is not the primary intervention for myxedema coma. While infections can precipitate myxedema coma and should be treated if present, the immediate priority is to address the severe hypothyroidism with thyroid hormone replacement. Antibiotics may be administered if an infection is suspected or confirmed, but they do not directly address the underlying thyroid hormone deficiency.

Choice C Reason:

Administering corticosteroids immediately is important but not the highest priority. Corticosteroids are often given to patients with myxedema coma to treat potential adrenal insufficiency, which can coexist with severe hypothyroidism. However, the primary intervention remains the administration of thyroid hormone replacement to correct the hypothyroid state.

Choice D Reason:

Initiating fluid restriction is not appropriate for managing myxedema coma. Patients with myxedema coma often require careful fluid management to address potential hyponatremia and maintain hemodynamic stability. Fluid restriction is not a standard intervention for this condition and does not address the critical need for thyroid hormone replacement.

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A 65-year-old patient has just received a blood transfusion. Shortly after the transfusion begins, the patient complains of chills, back pain, and difficulty breathing. What is the most likely cause of these symptoms?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is educating a patient on proper hearing aid care and maintenance. Which of the following statements should the nurse include in the teaching?

Correct Answer is A

Explanation

A 65-year-old patient is admitted to the ICU with myxedema coma. Which of the following interventions is the priority for this patient?

Correct Answer is A

Explanation

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