Identify the blood groups which cause ABO incompatibility?

SGPGI Nursing Officer-2022

Medical & Surgical Nursing

Medium

Appeared in: SGPGI Nursing Officer-2022

Explanation

ABO incompatibility occurs when a recipient's plasma contains antibodies that attack the antigens on a donor's red blood cells (RBCs).
A person with Blood Group B has Anti-A antibodies in their plasma.
A person with Blood Group A has A antigens on their RBCs.
When a B+ recipient receives blood from an A+ donor, the recipient's Anti-A antibodies will attack the donor's A antigens, causing a hemolytic reaction.
This immune response leads to the clumping (agglutination) and destruction (hemolysis) of the transfused red blood cells.

Option B: This is a compatible transfusion. The AB+ recipient has no anti-A or anti-B antibodies, so they can safely receive blood from an AB+ donor. People with AB+ blood are known as universal recipients.
Option C: This is a compatible transfusion because the donor and recipient have the same blood type (O+).
Option D: This is a compatible transfusion because the donor and recipient have the same blood type (B+).

Clinical Relevance

Nursing practice connection: Knowing ABO blood group incompatibility and principles of blood transfusion helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Preventing transfusion reactions is a critical patient safety responsibility for nurses. This involves meticulous verification of patient identity and blood product compatibility before administration.
Nurses must be able to rapidly identify the signs and symptoms of an acute hemolytic transfusion reaction (e.g., fever, chills, back pain, hypotension, dark urine) and initiate immediate life-saving interventions.
The primary nursing action for a suspected transfusion reaction is to stop the transfusion immediately, maintain IV access with normal saline using new tubing, and notify the provider and blood bank.

How to Approach the Question

First, understand the core principle of ABO incompatibility: a reaction occurs if the recipient's plasma antibodies match the donor's red blood cell antigens.
Recall the antigens and antibodies for each blood type: Type A (A antigen, anti-B antibody), Type B (B antigen, anti-A antibody), Type AB (A & B antigens, no antibodies), Type O (no antigens, anti-A & anti-B antibodies).
For each option, identify the donor's antigens and the recipient's antibodies.
Option A: Donor is A+ (A antigen), Recipient is B+ (anti-A antibody). This is a mismatch. The recipient's antibodies will attack the donor's cells.
Options B, C, and D: The donor and recipient have the same blood type. These are compatible transfusions.
Conclude that the scenario in Option A is the only one that causes ABO incompatibility.

Concept Tested & Keywords

Concept Tested: ABO blood group incompatibility and principles of blood transfusion.
Stem keywords: blood groups, ABO incompatibility, donor, recipient
Lead-in keywords: Identify

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