A client receiving a blood transfusion begins to develop hypotension. Which additional finding would most likely indicate the client is experiencing a hemolytic reaction?
Dark urine and back pain
Itchy skin and a mild rash
Bradycardia and elevated serum lactate dehydrogenase (LDH)
Hemolytic reactions are characterized by the destruction of transfused red blood cells. Dark urine (due to hemoglobinuria) and back pain are classic indicators linked to hemolysis and associated stress on the kidneys. Hypotension often accompanies these findings as a systemic response. Itchy skin and mild rashes are more indicative of an allergic reaction to the transfusion, not hemolysis. Bradycardia with elevated LDH might suggest cellular breakdown, but bradycardia is not commonly associated with hemolytic reactions—tachycardia would be more likely in this scenario.
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