A nurse is monitoring a client who is receiving a blood transfusion. Which of the following findings indicates an allergic transfusion reaction?
A.
Generalized urticaria.
B.
Distended jugular veins.
C.
Blood pressure 184/92 mm Hg.
D.
Bilateral flank pain.
The Correct Answer and Explanation is:
The correct answer is A. Generalized urticaria.
An allergic transfusion reaction is one of the potential complications that can occur when a patient receives a blood transfusion. This type of reaction, also known as a mild allergic reaction, occurs when the recipient’s immune system responds to proteins in the donor’s blood. It is often characterized by signs of an allergic response.
Key Findings of an Allergic Transfusion Reaction:
- Generalized Urticaria (Hives): Urticaria, or hives, is a hallmark sign of an allergic transfusion reaction. It involves red, raised, itchy welts that appear on the skin. The reaction typically occurs within minutes to a few hours of starting the transfusion. Urticaria can be isolated or generalized across the body, indicating an immune response to allergens in the transfused blood product.
- Itching: Along with urticaria, clients often report intense itching. This is due to the release of histamine, which is part of the body’s immune response during an allergic reaction.
- Mild Respiratory Symptoms: Some clients may develop mild respiratory symptoms such as wheezing, shortness of breath, or coughing due to bronchoconstriction, though these are less common in mild allergic reactions.
Explanation of Other Options:
- B. Distended Jugular Veins: This is a sign of circulatory overload or heart failure, which can occur in a transfusion reaction known as transfusion-associated circulatory overload (TACO). It is not associated with allergic reactions.
- C. Blood Pressure 184/92 mm Hg: Elevated blood pressure may indicate a hypertensive response or circulatory overload but is not a typical sign of an allergic reaction. Instead, mild allergic reactions typically do not cause significant blood pressure changes.
- D. Bilateral Flank Pain: This finding is associated with a hemolytic transfusion reaction, which occurs when there is an immune response to incompatible blood. Hemolysis results in the destruction of red blood cells, leading to flank or back pain as the kidneys attempt to filter the byproducts.
Management of an Allergic Reaction:
If a patient shows signs of an allergic transfusion reaction, such as generalized urticaria, the transfusion should be stopped immediately. Antihistamines, such as diphenhydramine, are typically administered to manage symptoms. The reaction is usually mild and self-limiting, but in rare cases, it can progress to more severe forms, such as anaphylaxis, which requires prompt intervention with epinephrine.
In summary, generalized urticaria is the key indicator of an allergic transfusion reaction, and prompt recognition and intervention are crucial for patient safety.