護理師評估接受輸血的病人。下列哪些發現代表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 findings indicate a hemolytic transfusion reaction? (Select all that apply.)
- ALow back pain✓ 正解腰痛
- BHypotension✓ 正解低血壓
- CFever and chills✓ 正解發燒和畏寒
- DUrticaria蕁麻疹
- EHemoglobinuria✓ 正解血紅素尿
溶血性輸血反應（hemolytic transfusion reaction）是一種嚴重的免疫性溶血事件，通常是因為 ABO 血型不符所致。臨床表現包括：輸血部位疼痛、發燒、寒顫、腰痛（腎臟受損跡象）、低血壓與血紅素尿（腎臟排泄損壞紅血球）。蕁麻疹（Urticaria）通常屬於過敏性反應，而非溶血性反應。護理師若發現這些徵象，必須立即停止輸血，並維持管路暢通，通知醫師。
A hemolytic transfusion reaction is a severe immune-mediated hemolytic event, usually caused by ABO incompatibility. Clinical manifestations include pain at the transfusion site, fever, chills, low back or flank pain (a sign of renal injury), hypotension, and hemoglobinuria (renal excretion of destroyed red cells). Urticaria is typically a manifestation of an allergic reaction rather than hemolysis. If these signs occur, the nurse must immediately stop the transfusion, maintain IV access, and notify the physician.