All of the following are the side effect of blood transfusion, except?

Appeared in: HPSSSB Staff Nurse - 2016

Explanation

Hypercalcaemia, or an elevated level of calcium in the blood, is not a recognized side effect of blood transfusion.
The opposite condition, hypocalcaemia (low calcium), is a common complication.
This occurs because the citrate anticoagulant used to preserve stored blood binds with the recipient's free (ionized) calcium, effectively reducing the amount available for bodily functions.

Option A: This is a known side effect. Hypocalcaemia occurs because the citrate anticoagulant in stored blood chelates (binds to) the recipient's serum calcium.
Option B: This is a known side effect. Hypothermia can result from the rapid infusion of large volumes of cold, refrigerated blood, which lowers the patient's core body temperature.
Option C: This is a known side effect. Stored blood becomes progressively more acidic due to ongoing red blood cell metabolism, leading to an accumulation of lactic acid. Transfusing this can contribute to metabolic acidosis in the recipient.

Clinical Relevance

Nursing practice connection: Knowing Metabolic complications of blood transfusion helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must monitor patients closely during transfusions for signs of hypocalcaemia (e.g., tingling around the mouth, muscle cramps, tetany) and hypothermia (e.g., shivering, decreased temperature).
Using a blood warmer is a critical nursing intervention during rapid or massive transfusions to prevent hypothermia and associated cardiac arrhythmias.
What if? If the patient had pre-existing renal failure, the risk of both hyperkalemia (from potassium leakage in stored blood) and citrate-induced hypocalcemia would be significantly higher, requiring more intensive monitoring of electrolytes and cardiac rhythm.

How to Approach the Question

First, identify the keywords in the question: "side effect," "blood transfusion," and the crucial negative lead-in "except."
The word "except" signals that you must find the option that is NOT a side effect of blood transfusion.
Systematically evaluate each option based on your knowledge of transfusion reactions.
Recall the properties of stored blood: it is cold, contains citrate as an anticoagulant, and becomes acidic over time.
Analyze how these properties affect the recipient: cold temperature causes hypothermia; citrate binds calcium, causing hypocalcaemia; and the acidic load can cause acidosis.
Conclude that hypocalcaemia, hypothermia, and acidosis are all potential side effects.

Concept Tested & Keywords

Concept Tested: Metabolic complications of blood transfusion
Stem keywords: side effect, blood transfusion
Lead-in keywords: except
Negative lead-in flag: The question asks for the exception among the given options.

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E6 Medicine Harrison 22e Part 1 p. 953-955

Practise the full HPSSSB Staff Nurse - 2016

Attempt every question from this paper in a timed mock, then review the full solution for each one.