A nurse is preparing to administer medication to a client.
Which of the following identifiers should the nurse use to identify the client?

Choice A rationale

An acute hemolytic transfusion reaction is a severe and life-threatening reaction caused by an incompatibility between the donor's blood and the client's blood. The recipient's antibodies attack and destroy the transfused red blood cells, leading to hemolysis. The classic symptoms include chills, fever, low-back pain, tightness in the chest, and headache. This reaction is a medical emergency requiring immediate cessation of the transfusion and supportive care.

Choice B rationale

An allergic reaction to a blood transfusion is typically caused by the recipient's antibodies reacting to a foreign plasma protein in the donor blood. Symptoms can range from mild, such as hives and itching, to severe, such as anaphylaxis. However, symptoms like low-back pain and a feeling of "tightness" in the chest are more characteristic of a hemolytic reaction rather than a simple allergic response.

Choice C rationale

A febrile nonhemolytic transfusion reaction is the most common type of transfusion reaction. It is caused by the recipient's antibodies reacting to donor white blood cells. Symptoms include fever and chills, but typically do not include the severe manifestations of low-back pain, headache, and chest tightness that are seen in a hemolytic reaction. The reaction is usually not life-threatening.

Choice D rationale

Transfusion-related acute lung injury (TRALI) is a serious and potentially fatal complication of a transfusion. It is characterized by the sudden onset of non-cardiogenic pulmonary edema within six hours of a transfusion. Symptoms primarily involve respiratory distress, such as dyspnea and hypoxemia. While TRALI is severe, the symptoms presented, particularly the low-back pain and chest tightness, are more indicative of an acute hemolytic reaction. .

Choice A rationale

Storing transdermal scopolamine patches in the refrigerator is incorrect. Scopolamine patches are designed to be stored at controlled room temperature, typically between 20 to 25 degrees Celsius, to maintain the integrity of the adhesive and the stability of the medication. Refrigeration can compromise the patch's adhesive properties, potentially causing it to fall off, and may also affect the rate of drug delivery.

Choice B rationale

Replacing a dislodged patch onto the same location is incorrect. The skin's absorption capabilities at the initial site may be reduced due to the previous application, leading to a diminished therapeutic effect. Applying a new or dislodged patch to a new, clean, and dry site, typically behind the ear, ensures optimal drug absorption and efficacy, which is a crucial aspect of patient education.

Choice C rationale

Applying the patch prior to traveling is correct. Transdermal scopolamine requires a significant onset time to achieve therapeutic blood levels to effectively prevent the symptoms of motion sickness. The recommendation is to apply the patch at least four hours before the anticipated travel to allow for sufficient absorption and systemic distribution of the medication to the central nervous system.

Choice D rationale

Placing the patch on the upper arm is incorrect. The recommended application site for transdermal scopolamine is the postauricular area, which is the hairless skin behind the ear. This location offers a thin epidermis and a rich capillary network, facilitating consistent and effective absorption of the medication into the systemic circulation, which is essential for its prophylactic antiemetic effect. *.