The nurse is caring for a client who suddenly developed severe respiratory distress 2 hours after a blood transfusion. The health provider is notified and a diagnosis of transfusion-related acute lung injury (TRALI) is made
The nurse understands that this client may: 1. Never have another transfusion from the same donor.
2. Never have another transfusion again from any donor.
3. Have transfusions again because the donor did not precipitate this event.
4. Have family members who cannot ever have transfusions.
Never have another transfusion from the same donor.
Rationale: The exact cause of this complication is not fully understood. One prevailing theory is that TRALI is thought to be caused by the presence of granulocyte antibodies and biologically active lipids in the donor plasma that the recipient reacts to. If antibodies are present in the donor's plasma, they stimulate the WBCs in the recipient's blood. Aggregates of WBCs form and occlude the microvasculature of the lungs. All plasma-containing blood components, including RBCs, platelets, FFP, and cryoprecipitates, can be a cause of TRALI. Once TRALI has occurred, the recipient should not receive any more transfusions from the same donor. Transfusion from other donors poses no increased risk.
It is acceptable to have another transfusion from another donor. Family members should be informed, but it is not an indication for them to not have transfusions
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