A nurse is monitoring a client who has just started a blood transfusion. After 30 minutes, the client reports shaking chills, muscle stiffness, and a temperature of 39 C (102.2 F) The client denies having any low back pain, nausea, chest tightness, dyspnea, and anxiety. Which type of transfusion reaction should the nurse suspect?

Rationale: A. Acute hemolytic reactions are typically caused by incompatible blood transfusions. They present with fever, chills, hypotension, low back pain, hemoglobinuria, dyspnea, and anxiety. The absence of low back pain, hypotension, or hemoglobinuria makes an acute hemolytic reaction less likely in this scenario. B. Septic transfusion reactions result from bacterial contamination of the blood product. Symptoms include high fever, chills, hypotension, tachycardia, and shock, often progressing rapidly. The client’s stable hemodynamics and absence of systemic signs of sepsis make this less likely. C. This is the most common type of transfusion reaction and is typically caused by antibodies to donor leukocytes. It presents with shaking chills, fever, and muscle stiffness, usually without hypotension, dyspnea, or hemoglobinuria. The reaction often occurs within the first 30–90 minutes of transfusion, matching this client’s presentation. D. Allergic reactions usually involve urticaria, pruritus, flushing, and sometimes angioedema. Fever and muscle stiffness are not typical, so this client’s symptoms are inconsistent with an allergic reaction.