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    Ati ew n300 med surg final proctored exam

    The nurse is monitoring a patient receiving a blood transfusion. For which symptoms would the nurse stop the transfusion but NOT administer 0.9% normal saline?

    Explanation & Rationale

    A. Symptoms like chest tightness, fever, chills indicate a febrile or hemolytic reaction where normal saline is administered after stopping transfusion. B. Low back pain, hypotension, and tachycardia suggest a hemolytic reaction; normal saline is given after stopping transfusion. C. Dyspnea, crackles, hypertension, and edema are signs of transfusion-associated circulatory overload (TACO). In TACO, fluid overload is the issue, so saline is NOT given; instead, diuretics and oxygen are used. D. Urticaria, itching, wheezing, angioedema suggest an allergic reaction, and normal saline is administered after stopping transfusion.

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