Fundamentals of Nursing Q 389

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Which of the following is a sign or symptom of a hemolytic reaction to blood transfusion?

  

     A. Hemoglobinuria

     B. Chest pain

     C. Urticaria

     D. Distended neck veins

    

    

Correct Answer: A. Hemoglobinuria

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Hemoglobinuria, the abnormal presence of hemoglobin in the urine, indicates a hemolytic reaction (incompatibility of the donor’s and recipient’s blood). In this reaction, antibodies in the recipient’s plasma combine rapidly with donor RBC’s; the cells are hemolyzed in either circulatory or reticuloendothelial systems. Hemolysis occurs more rapidly in ABO incompatibilities than in Rh incompatibilities.

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Option B: Flank pain is a common sign of hemolytic reaction. Symptoms of a hemolytic transfusion reaction most often appear during or right after the transfusion. Sometimes, they may develop after several days (delayed reaction).

Option C: Chest pain and urticaria may be symptoms of impending anaphylaxis. A hemolytic transfusion reaction is a serious complication that can occur after a blood transfusion. The reaction occurs when the red blood cells that were given during the transfusion are destroyed by the person’s immune system. When red blood cells are destroyed, the process is called hemolysis.

Option D: Distended neck veins are an indication of hypervolemia. Most of the time, a blood transfusion between compatible groups (such as O+ to O+) does not cause a problem. Blood transfusions between incompatible groups (such as A+ to O-) cause an immune response. This can lead to a serious transfusion reaction. The immune system attacks the donated blood cells, causing them to burst.

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