護理師評估一位接受輸血的病人。哪些跡象顯示發生溶血性輸血反應？（選所有適合的）
A nurse is assessing a client receiving a blood transfusion. Which signs suggest a hemolytic transfusion reaction? (Select all that apply.)
- ALow back pain✓ 正解下背痛
- BFever and chills✓ 正解發燒與畏寒
- CTachycardia✓ 正解心搏過速
- DWheezing喘鳴
- EHypotension✓ 正解低血壓
急性溶血性輸血反應（Acute Hemolytic Transfusion Reaction）通常發生在輸血後短時間內，由於受贈者抗體攻擊供血者的紅血球，引發免疫反應。這會釋放自由血紅素，導致腎小管阻塞、血管擴張及凝血異常，臨床表現包含發燒、寒顫、下背痛（腎臟區域血管收縮與發炎反應）、心搏過速與低血壓（休克表現）。若懷疑反應，必須立即停止輸血並維持靜脈管路暢通（使用生理食鹽水）。
Acute hemolytic transfusion reaction typically occurs shortly after transfusion begins, when the recipient's antibodies attack the donor's red blood cells and trigger an immune response. The release of free hemoglobin leads to renal tubular obstruction, vasodilation, and coagulation abnormalities. Clinical manifestations include fever, chills, low back pain (from renal-region vasoconstriction and inflammation), tachycardia, and hypotension (signs of shock). If a reaction is suspected, the transfusion must be stopped immediately while maintaining IV access with normal saline.