A nurse is assessing a client who is receiving a unit of packed red blood cells. Which client statement suggests manifestation of an acute hemolytic reaction?
"I have sharp pain in my lower back."
"I am coughing a lot more now."
"I hear ringing in my ears."
"I feel needles poking in my feet."
The Correct Answer is A
A. Sharp pain in the lower back is a classic symptom of an acute hemolytic reaction, which can occur due to incompatible blood transfusions.
B. Coughing more could indicate a transfusion-related acute lung injury (TRALI) but is not a typical sign of an acute hemolytic reaction.
C. Ringing in the ears can occur with other conditions but is not a common sign of an acute hemolytic reaction.
D. Feeling needles poking in the feet is vague and not specifically associated with acute hemolytic reactions, which are characterized by more severe systemic symptoms.
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Correct Answer is C
Explanation
A. Dietary iron restrictions may affect iron intake, but they are not a direct symptom of ulcerative colitis that contributes to anemia.
B. Intestinal parasites can cause anemia but are not a common complication associated with ulcerative colitis.
C. Chronic bloody diarrhea is a significant symptom of ulcerative colitis and leads to iron loss and depletion, contributing to the development of anemia due to the loss of blood and iron.
D. Intestinal malabsorption syndrome can lead to anemia; however, it is not a primary symptom of ulcerative colitis itself, making chronic bloody diarrhea the more direct contributing factor.
Correct Answer is D
Explanation
A. Encouraging frequent ambulation is not appropriate during a vaso-occlusive crisis, as it can exacerbate pain and further compromise blood flow.
B. While monitoring the RBC count is important, it is not the most immediate intervention during a crisis. The focus should be on managing pain and preventing complications.
C. Treating the client in an outpatient setting is inappropriate during a vaso-occlusive crisis, which typically requires inpatient care for effective pain management and hydration.
D. Maintaining IV fluids, administering pain medications, and providing supplemental oxygen are critical interventions that address the acute needs of the client in crisis, aiming to alleviate pain and improve oxygenation.