A nurse remains with a client to observe for any adverse reactions after initiating a transfusion of packed RBCs. The client becomes apprehensive and tachycardic. reporting headache and low back pain. The nurse should recognize that these findings indicate which of the following transfusion reactions?
Hemolytic
Allergic
Febrile
Bacterial
The Correct Answer is A
A. Hemolytic: Acute hemolytic transfusion reactions can occur quickly after starting a transfusion and present with symptoms such as fever, chills, headache, low back pain, tachycardia, and apprehension. It is a serious reaction caused by the destruction of transfused red blood cells.
B. Allergic: Allergic reactions to blood transfusions typically present with hives, itching, and anaphylaxis, not low back pain or tachycardia.
C. Febrile: Febrile reactions involve fever and chills but not typically headache or back pain.
D. Bacterial: Bacterial contamination of blood can cause fever and chills, but not specifically the symptoms of headache and low back pain described.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. 2 hr after obtaining blood from the blood bank. Blood should be started as soon as possible, ideally within 30 minutes to minimize the risk of bacterial growth. Waiting for 2 hours is not appropriate.
B. When the client states he is ready to start the infusion. The client’s readiness should be considered, but the timing should be based on clinical guidelines and safety protocols, not just the client’s preference.
C. As soon as the nurse can prepare the client and the administration set. Blood products should be infused as soon as possible after preparation to reduce the risk of bacterial contamination and ensure efficacy.
D. When the client has finished eating lunch. The infusion timing should not be delayed for non-essential reasons like meal completion unless the client is experiencing issues that could interfere with the transfusion.
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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