An 82-year-old client with CHF develops acute dyspnea, jugular venous distention, hypertension, and crackles 9…

Question

An 82-year-old client with CHF develops acute dyspnea, jugular venous distention, hypertension, and crackles 90 minutes into a 2-unit PRBC transfusion. Which is the most likely reaction and priority action?

Accepted Answer

Option 4: TACO (transfusion-associated circulatory overload) — slow or stop the transfusion, sit upright, supplemental O2, IV diuretic (furosemide), notify provider

Correct (2): TACO — circulatory overload from rapid/large-volume transfusion, especially in elderly/CHF/CKD. Signs: dyspnea, JVD, HTN, crackles, S3, rising BNP. Management: slow/stop transfusion, sit upright, O2, IV furosemide. Prevention: pre-transfusion diuretic, slower rate. TRALI differs — hypotension + non-cardiogenic pulmonary edema within 6 hours; treat with respiratory support. (1) TRALI has hypotension. (3) Anaphylaxis = hives + wheeze. (4) Septic = chills + fever shock.

Answer

Option 1: Anaphylaxis — administer epinephrine

Answer

Option 2: Septic reaction — administer antibiotics

Answer

Option 3: TRALI — administer 2L bolus and continue

An 82-year-old client with CHF develops acute dyspnea, jugular venous distention, hypertension, and crackles 90 minutes into a 2-unit PRBC transfusion. Which is the most likely reaction and priority action?

In-depth explanation

Clinical scenario

Key concepts

Master the NCLEX-RN with MyMerci

성장을 멈추지 마세요

An 82-year-old client with CHF develops acute dyspnea, jugular venous distention, hypertension, and crackles 90 minutes into a 2-unit PRBC transfusion. Which is the most likely reaction and priority action?

In-depth explanation

Clinical scenario

Key concepts

Master the NCLEX-RN with MyMerci