A nurse is monitoring a client who is receiving a blood transfusion. Which of the following findings indicates an allergic transfusion reaction?

Choice A rationale A blood pressure of 184/92 mm Hg, indicating hypertension, is not a typical or primary sign of an allergic transfusion reaction. Allergic reactions often lead to vasodilation and hypotension due to widespread histamine release. Elevated blood pressure might suggest fluid overload or another co-existing condition, but not allergic response. Choice B rationale Bilateral flank pain is a characteristic symptom of an acute hemolytic transfusion reaction, where the recipient's antibodies attack and destroy transfused red blood cells. This symptom is related to renal damage and is distinct from the immunological mechanisms of an allergic reaction. Choice C rationale Distended jugular veins are indicative of fluid volume overload or cardiac decompensation, which can be a complication of rapid intravenous fluid administration during a transfusion. However, this is a circulatory finding, not a direct manifestation of an allergic hypersensitivity reaction. Choice D rationale Generalized urticaria, or the presence of hives all over the body, is a common and hallmark sign of an allergic transfusion reaction. This reaction is mediated by mast cell and basophil degranulation, releasing histamine that causes increased vascular permeability and pruritic skin lesions.