A nurse is caring for a client who is receiving a unit of packed red blood cells. Fifteen minutes following the start of the transfusion, the nurse notes that the client is febrile, with chills and red-tinged urine. Which of the following transfusion reactions should the nurse suspect?

Allergic

Acute pain

Febrile

Hemolytic

Answer and Explanation

The Correct Answer is D

A. Allergic: Allergic reactions typically involve symptoms such as hives, itching, and sometimes anaphylaxis, but not usually fever, chills, or hematuria (red-tinged urine).

B. Acute pain: Acute pain transfusion reaction is characterized by severe pain but not usually accompanied by fever, chills, or hematuria.

C. Febrile: Febrile reactions involve fever and chills but do not typically include red-tinged urine, which indicates hemolysis of red blood cells.

D. Hemolytic: A hemolytic transfusion reaction involves the destruction of red blood cells, leading to fever, chills, and red-tinged urine due to the presence of hemoglobin from lysed red cells in the urine.

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Correct Answer is ["B","E"]

Explanation

A. Massage over erythematous bony prominences: Incorrect. Massaging over areas of erythema (redness) can cause further damage to the underlying tissues and should be avoided. It may exacerbate tissue injury and increase the risk of skin breakdown.

B. Use pillows to keep heels off the bed surface: Correct. Elevating the heels with pillows helps to reduce pressure and prevent pressure ulcers by keeping them off hard surfaces. This is a recommended practice to reduce the risk of heel pressure ulcers.

C. Implement turning schedule every 4 hr: Incorrect. A turning schedule of every 2 hours is generally recommended to prevent pressure ulcers. Four hours is too long and increases the risk of skin breakdown in immobile patients.

D. Keep the client's skin dry with powder: Incorrect. Powders can dry out the skin and increase friction, potentially leading to skin breakdown. It's more important to maintain moisture balance and avoid the use of powders on skin at risk.

E. Minimize skin exposure to moisture: Correct. Moisture can contribute to skin breakdown, especially in incontinent patients. It is crucial to keep the skin clean and dry to prevent moisture-associated skin damage.

A. Steak B. Low fat milk C. Grilled salmon D. Green leafy vegetables E. Scrambled eggs

Correct Answer is ["A","B","C","E"]

Explanation

A. Steak - Red meats like steak are high in vitamin B12, making them an excellent choice for individuals with B12 deficiency.

B. Low fat milk - Dairy products, including milk, are good sources of vitamin B12 and should be included in the diet.

C. Grilled salmon - Fish such as salmon is rich in vitamin B12, making it a beneficial food for addressing B12 deficiency.

D. Green leafy vegetables - While nutritious, green leafy vegetables are not significant sources of vitamin B12. B12 is primarily found in animal products.

E. Scrambled eggs - Eggs contain a good amount of vitamin B12, making them a suitable option for dietary management of deficiency.

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A nurse is caring for a client who is receiving a unit of packed red blood cells. Fifteen minutes following the start of the transfusion, the nurse notes that the client is febrile, with chills and red-tinged urine. Which of the following transfusion reactions should the nurse suspect?

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