— 降低風險 · HARD · SATA —
護理師照護一位正在進行輸血的病人。下列哪些症狀顯示病人發生了急性溶血性輸血反應？（選所有適合的）
A nurse is caring for a client receiving a blood transfusion. Which signs and symptoms indicate an acute hemolytic transfusion reaction? (Select all that apply.)
- ALow back pain✓ 正解背痛
- BFever and chills✓ 正解發燒與畏寒
- CHypotension✓ 正解低血壓
- DWheezing哮鳴音
- EHemoglobinuria✓ 正解血紅素尿
— Explanation · 中文詳解 —
急性溶血性反應是因為 ABO 血型不符導致紅血球被摧毀。其經典表現為腰痛（腎臟受損）、發燒發冷、低血壓、休克及血紅素尿（游離血紅素排泄）。哮鳴（Wheezing）通常與過敏性反應相關，而非溶血性反應的主要徵兆。
An acute hemolytic reaction results from destruction of red blood cells due to ABO incompatibility. Its classic features include low back pain (from renal injury), fever and chills, hypotension, shock, and hemoglobinuria (from excretion of free hemoglobin). Wheezing is generally associated with allergic reactions and is not a primary indicator of a hemolytic reaction.
✦ 台美臨床差異
美國輸血前需經由兩位護理師雙重簽核；台灣亦有此規定，但常伴隨電子條碼辨識系統減少人為錯誤。