A nurse is assessing a client who is receiving a unit of packed RBCs. Which of the following findings indicates the client is having a hemolytic transfusion reaction?

A. Bounding pulses may be seen with fluid overload but are not specific to a hemolytic transfusion reaction. B. Low back pain is a classic sign of a hemolytic transfusion reaction, caused by the destruction of red blood cells and resulting in inflammation and renal impairment. C. Distended jugular veins indicate fluid overload or heart failure, not a hemolytic reaction. D. “Pretension” appears to be a typographical error; if it refers to hypertension, it is not a hallmark sign of a hemolytic reaction. Fever, chills, hypotension, and flank or low back pain are more typical signs.