💉 NCLEX Blood Transfusion Reactions: A Visual & Clinical Guide

Blood transfusions are lifesaving — but when they go wrong, the results are rapid and dangerous.
NCLEX expects you to quickly recognize symptoms, stop the transfusion, and take the right next steps.

Today’s blog breaks it down with a King of the Curve visual, reaction comparison table, and a quick action checklist.

📊 Types of Blood Transfusion Reactions

Reaction Type	Key Symptoms	NCLEX Focus
Hemolytic	Flank pain, fever, chills, hypotension, hemoglobinuria	ABO incompatibility; STOP transfusion immediately
Febrile Non-Hemolytic	Chills, fever, headache	Most common; not life-threatening
Allergic (Mild)	Urticaria, itching, flushing	Treat with antihistamines; may restart
Anaphylactic	Wheezing, dyspnea, chest tightness, hypotension	Emergency! Airway support, epinephrine
Septic	High fever, chills, hypotension, shock	Contaminated blood; start antibiotics & cultures

🧠 NCLEX Tip: What to Do First?

If you suspect a reaction:

1. STOP the transfusion

2. Keep the IV line open with normal saline

3. Notify provider and blood bank

4. Monitor vitals

5. Send blood and tubing for analysis

🩺 Pre-Transfusion Nursing Checklist

• Verify patient ID and blood compatibility

• Baseline vital signs

• Stay with patient first 15 minutes

• Infuse slowly at start

• Educate patient to report chills, back pain, or itching

💡 Mnemonic: “FASH”

F – Fever
A – Allergic symptoms
S – Sepsis (shock signs)
H – Hemolytic (hypotension, hematuria)

🏁 Final Thoughts

Transfusion safety is a must-know for NCLEX med-surg, and these reactions are classic testable material.
When in doubt: stop the blood, support the patient, and call for help.

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