A client is suspected of having a reaction to an antigen. Which lab test would alert the nurse regarding the possibility of a hypersensitivity reaction?
1. Eosinophils of 2% of the total WBC
2. Indirect Coombs' showing no agglutination
3. Patch test with a one-inch area of erythema
1. Rh antigen with negative results
3. Patch test with a one-inch area of erythema
Rationale:
A patch test assesses a one-inch area impregnated with the allergen, which is applied for 48 hours. Absence of a response indicates a negative result. Positive responses are graded from mild (erythema in the exposed area) to severe (papules, vesicles, or ulcerations). Direct Coombs' test detects antibodies in the client's RBC that damage and destroy the cells. This is used following a suspected transfusion reaction to detect antibodies coating the transfused RBCs. This is also part of the crossmatch of a blood type and crossmatch. Indirect Coombs' test detects the presence of circulating antibodies against RBCs. The eosinophil count is 1–4%, which is within normal range.
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