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This chapter is from the book

This chapter is from the book

Transfusion Reactions

When clients lack blood or blood components, it might be necessary for these components to be replaced. Possible causes of the need for a transfusion include trauma, red blood cell destruction disorders, and bone marrow depression. Table 10.2 outlines types of reactions associated with blood transfusions. Study the symptoms extensively and expect to see items related to reactions on your nursing exams.

Table 10.2. Blood Transfusion Reactions

Type of Reaction



Hemolytic (due to blood type or Rh incompatibility)

Headache, chest pain, anxiety, lower back pain, hypotension, tachycardia, tachypnea, hemoglobinemia, bronchospasm, vascular collapse

Stop blood transfusion. Send tubing and blood to laboratory. Maintain blood volume and renal perfusion.

Febrile reaction

Chills, tachycardia, fever, hypotension

Antipyretic administration; pretreat with future transfusions or give washed RBCs.

Allergic reaction (patient usually has a history of allergies)

Urticaria, itching, respiratory distress, anaphylaxis

Pretreat with antihistamine.

Bacterial reaction due to contaminated blood (not a common occurrence)

Tachycardia, hypotension, fever, chills, shock

Same treatment as septic shock.

Circulatory overload (more likely in elderly, children, and clients with multiple transfusions of whole blood)

Symptoms of congestive heart failure: hypertension, bounding pulse, distended neck veins

Monitor intake and output. Infuse blood slowly. Administer ordered diuretics.

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