A nurse is monitoring a client who is receiving 2 units packed RBCs. Which of the following manifestations indicates a hemolytic transfusion reaction?

Bradycardia

Hypertension

Chills

Back pain

Answer and Explanation

The Correct Answer is D

Back pain is a common symptom of a hemolytic transfusion reaction, which occurs when the recipient's immune system attacks and destroys the donor's red blood cells. Other symptoms include fever, chills, dyspnea, chest pain, hypotension, tachycardia, hemoglobinuria, and jaundice. A hemolytic transfusion reaction is a medical emergency that requires immediate intervention.

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Correct Answer is A

Explanation

Bananas are one of the fruits that contain proteins similar to those found in natural rubber latex, which can cause an allergic reaction in some people. This is called latex-fruit syndrome and can also occur with other fruits such as avocado, kiwi, chestnut, and papaya. The client should inform the surgical team about their banana allergy and avoid contact with latex products such as gloves, catheters, syringes, and bandages.

A. Instruct the client to avoid eating raw fruit. B. Use contact isolation while providing care. C. Apply pressure to venipuncture sites for 10 min. D. Move the client to a negative pressure room.

Correct Answer is A

Explanation

The client has neutropenia, which is a low number of neutrophils, a type of white blood cell that fights infection. The client is at risk for developing infections from bacteria and fungi that are normally present in the environment. Raw fruits may contain these microorganisms and should be avoided.

Contact isolation is not necessary for neutropenic clients, unless they have an active infection. Applying pressure to venipuncture sites for 10 min is a standard precaution for all clients, not specific to neutropenic clients. Moving the client to a negative pressure room is indicated for clients with airborne infections, not neutropenic clients.

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A nurse is monitoring a client who is receiving 2 units packed RBCs. Which of the following manifestations indicates a hemolytic transfusion reaction?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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