🩸 Blood Transfusion Reactions: NCLEX Signs, Types & Emergency Actions

Transfusions save lives — but when they go wrong, they go wrong fast.

Recognizing early signs and responding correctly is critical on the NCLEX and in clinical practice.

This KOTC visual guide covers the four main reaction types, key symptoms, and nursing priorities.

🚨 Types of Blood Transfusion Reactions

Reaction Type	Key Symptoms	Nursing Priority
Acute Hemolytic	Fever, chills, back pain, hypotension, hemoglobinuria	Stop transfusion, maintain IV access with NS
Febrile Non-Hemolytic	Fever, chills, headache, flushing	Stop transfusion, give antipyretics
Mild Allergic	Hives, itching, flushing	Stop temporarily, give antihistamines
Anaphylactic	Dyspnea, hypotension, bronchospasm, shock	Stop transfusion, call rapid response, give epinephrine

📌 Early Signs to Recognize

• Fever or chills

• New onset back/chest pain

• Hypotension

• Dyspnea or wheezing

• Anxiety or feeling of doom

• Dark urine (hemoglobinuria)

Always monitor vital signs closely during the first 15 minutes of any transfusion — reactions often occur early.

🧠 NCLEX-Style Question

A patient develops chills, back pain, and hypotension 10 minutes into a transfusion. What is the nurse’s first action?

✅ Answer: Stop the transfusion immediately and maintain IV access with normal saline.

🩺 Nursing Actions for Transfusion Reaction

1. STOP the transfusion immediately.

2. Keep IV open with normal saline (new tubing).

3. Notify provider and blood bank.

4. Monitor vitals closely.

5. Send blood bag and tubing to lab for analysis.

6. Administer medications as ordered (antihistamines, epinephrine, corticosteroids).

💡 Mnemonic: “STOP BLOOD”

S – Stop transfusion
T – Take vitals
O – Open new IV line with NS
P – Provider and blood bank notification
B – Bag and tubing sent to lab
L – Look for signs: fever, rash, dyspnea
O – Oxygen PRN
O – Order medications (antihistamines, epinephrine)
D – Document thoroughly

📲 Level Up with King of the Curve

• 🩸 Transfusion reaction flashcards

• 🎯 Emergency timed QBank

• 📖 Cheat sheets for NCLEX prioritization

Explore the full nursing collection at kingofthecurve.org/studyscience

🏁 Final Thoughts

The NCLEX loves to test blood transfusion reactions because they require fast, critical nursing judgment. With these signs, mnemonics, and KOTC visuals, you’ll react like a pro.

📥 Get the King of the Curve App

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