Immediate side effect of blood transfusion is:

IGNOU PB Bsc Entrance-2022

Medical & Surgical Nursing

Easy

Appeared in: IGNOU PB Bsc Entrance-2022

Explanation

Anaphylactic shock is a severe, life-threatening Type I hypersensitivity reaction that can occur within seconds to minutes of starting a blood transfusion.
It is often caused by anti-IgA antibodies in an IgA-deficient recipient reacting with IgA in the donor's blood.
Symptoms include sudden hypotension, bronchospasm, urticaria, and angioedema, requiring immediate cessation of the transfusion and emergency treatment.
The defining characteristic that makes it the correct answer is its extremely rapid onset, fitting the description of an 'immediate' side effect.

Option A: Increased urine output is not a recognized adverse effect of a blood transfusion. While a transfusion adds volume to the circulatory system, it does not typically cause an immediate and significant increase in urine production as a side effect.
Option B: While decreased urine output is a serious sign associated with a transfusion reaction, it is not an immediate one. It is a later manifestation of an acute hemolytic reaction, indicating the development of acute kidney injury due to hemoglobinuria and renal vasoconstriction.
Option D: Reduced skin turgor is a sign of dehydration or fluid volume deficit. A blood transfusion is a volume-expanding procedure, so it would counteract dehydration rather than cause it.

Clinical Relevance

Nursing practice connection: Knowing Immediate adverse reactions to blood transfusion helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A core nursing safety protocol is to remain with the patient for the first 15 minutes of a blood transfusion and monitor vital signs frequently, as this is the critical window when immediate, life-threatening reactions like anaphylaxis are most likely to occur.
Prompt recognition and immediate cessation of the transfusion are the most important interventions to prevent mortality from a severe transfusion reaction.
What if? If a patient develops a fever and chills 45 minutes after the transfusion starts, but has no respiratory distress or hypotension, the most likely cause is a febrile non-hemolytic transfusion reaction (FNHTR), not anaphylaxis. The intervention is still to stop the transfusion and notify the provider, but the urgency and treatment protocol differ (e.g., antipyretics for FNHTR vs. epinephrine for anaphylaxis).

How to Approach the Question

First, identify the key terms in the question: 'Immediate side effect' and 'blood transfusion'. The word 'immediate' is crucial, implying a reaction that occurs within seconds to a few minutes.
Next, evaluate each option based on its typical onset time in the context of a transfusion.
Consider 'Anaphylactic shock'. Recall that anaphylaxis is a rapid, systemic allergic reaction, making it a strong candidate for an 'immediate' effect.
Analyze 'Decreased urine output'. This is a sign of kidney damage, which is a process that takes time to develop, even in an acute setting. It is not an instantaneous event.
Evaluate 'Increased urine output' and 'Reduced skin turgor'. These are physiologically inconsistent with the immediate effects of a blood transfusion. A transfusion adds volume, it doesn't cause dehydration (reduced turgor), and it doesn't typically trigger immediate diuresis.
Based on this analysis, conclude that anaphylactic shock is the only option that represents a truly immediate, life-threatening side effect of a blood transfusion.

Concept Tested & Keywords

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