護理師評估一名接受輸血的病人。下列哪項發現應識別為溶血性輸血反應？
A nurse is assessing a client receiving a blood transfusion. Which finding should the nurse recognize as a sign of a hemolytic transfusion reaction?
- AItchy skin and urticaria皮膚搔癢和蕁麻疹
- BDry cough and chest congestion乾咳和胸部擁塞
- CWheezing and dyspnea哮鳴音和呼吸困難
- DLow back pain and flank pain✓ 正解背痛和側腹痛
溶血性輸血反應是由於 ABO 不相容引起的嚴重反應。紅血球破裂釋放血紅素，導致腎血管阻塞與發炎反應，臨床表現常出現下背部劇烈疼痛、側腰痛、發燒、畏寒、低血壓與血尿。這是輸血過程中極度危險的併發症，需立刻停止輸血。
A hemolytic transfusion reaction, often caused by ABO incompatibility, results in red blood cell destruction and the release of hemoglobin. This process can cause renal vascular obstruction and inflammation, clinically manifesting as severe low back pain and flank pain alongside fever, chills, and hypotension. Unlike allergic reactions which present with itching or wheezing, flank pain is a hallmark sign of hemolysis requiring immediate transfusion cessation.
美國輸血常需兩名護理師雙重核對，台灣亦同，但針對不良反應的通報系統與時間要求略有不同。