The nurse understands that the osmotic makeup of the blood causes fluid to be mobilized from the interstitial space, which increases the risk for:
1. Circulatory overload.
2. Hypovolemia.
3. Infection.
4. Transfusion reaction.
Circulatory overload.
Rationale: Circulatory overload can occur with transfusions because the increased osmotic makeup of the blood causes fluid to be mobilized from the interstitial space, thereby increasing intravascular volume well beyond that given during the transfusion. High-risk clients include the elderly and those individuals who already have increased circulatory volume or who have a history of heart failure. Hypovolemia is not a consideration because the volume is being increased, not decreased. Infections do not manifest themselves until after the completion of the transfusion and are not related to the osmolality of the blood. Transfusion reactions are not associated with the osmotic makeup of the blood.
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