Blood transfusion reaction

[Texas_goodnurse]

So I am doing hurst review and they said hypertension is one of the signs of transfusion reaction , but I read the other flash card reviewer and says its not! Now I'm confused, anyone have input?

[Jen_Jen88]

They could be going into a circulatory overload which is a reaction. Remember more volume = more pressure.

[nurseprnRN, BSN, RN]

Hypervolemia is not, strictly speaking, a blood "reaction." Hypervolemia usually results in decreased BP as the heart is overloaded (CHF). If this happens with a transfusion, the usual response is diuretics (furosemide, Lasix).

BP may rise with a blood transfusion if the patient was hypovolemic to begin with; a hypertensive overshoot is not something I'd expect. Hypertension is listed as a possible symptom or blood reaction (a constellation of allergic responses), but is rare. I think you're much better off remembering the common signs of blood incompatibility, including hypotension due to anaphylaxis, and they very well may ask you about them.

[Jen_Jen88]

In my Saunders it mentioned that one of the reactions of a blood transfusion was a circulatory overload which would cause the hypertension and even pulmonary edema due to the overload of "fluids" coming in which puts more workload on the heart.

[nurseprnRN, BSN, RN]

PULMONARY hypertension. What do you know about volume status and congestive heart failure?

[Jen_Jen88]

Well in CHF the left ventricle is weak so it cannot pump the blood out into the aorta and the body with enough force so the fluid begins to back up into the lungs

[LadyFree28, BSN, LPN, RN]

So I am doing hurst review and they said hypertension is one of the signs of transfusion reaction but I read the other flash card reviewer and says its not! Now I'm confused, anyone have input?[/quote']

WHAT was the question ASKING you...

I say this because it depends on what category the questions are in...is it a Safe, Effective Care question and answer, or is it a Physiologic Integrity question and answer???

Let us know the rationales for both questions and then let us know whether you need additional clarification.

[nurseprnRN, BSN, RN]

Well in CHF the left ventricle is weak so it cannot pump the blood out into the aorta and the body with enough force so the fluid begins to back up into the lungs

Bingo, and this makes for high blood pressure in the pulmonary capillary bed, which is why the fluid leaks out of the capillaries under pressure and into the alveoli, which is why people in CHF have wet chests that sound like waterfalls.

You can put someone into CHF by overloading him with fluid, including blood or blood products. If an unhealthy or old heart can't handle excess intravascular volume by responding with better contractility like a normal heart, CHF results.

[BrooklynRN11201]

Make sure you know the differences between circulatory overload (hypertension, crackles), allergic reaction (itching, etc.), hyperthermia reaction (high temp) and severe reactions (SOB, shock, etc.) and treatments for each - for example, if the pt experiences a minor allergic reaction, you can premedicate with Benadryl, but for NCLEX purposes ALWAYS stop transfusion. Pt safety first!

[born_this_way]

Make sure you know the differences between circulatory overload (hypertension, crackles), allergic reaction (itching, etc.), hyperthermia reaction (high temp) and severe reactions (SOB, shock, etc.) and treatments for each - for example, if the pt experiences a minor allergic reaction, you can premedicate with Benadryl, but for NCLEX purposes ALWAYS stop transfusion. Pt safety first!

first sign are back pain or hypertension