If a client who is receiving a blood transfusion develops fever, chills, and low back pain, what action would the nurse take first?

• A. Stop the blood transfusion and infuse saline.
• B. Administer the prescribed antipyretic.
• C. Obtain a prescription for an antihistamine.
• D. Notify the blood bank about the symptoms.

Answer: (A)

When a client receiving a blood transfusion develops fever, chills, and back pain, the priority is recognizing a potential transfusion reaction and acting immediately to prevent further harm. The first action is to stop the transfusion to halt any ongoing reaction and avoid more donor blood from entering the body. At the same time, keep an IV line open with normal saline to maintain perfusion and to flush any remaining blood product from the line. This rapid step reduces the risk of escalating hemolysis and kidney injury.

After stopping the transfusion and securing IV access, notify the provider and the transfusion service or blood bank, and begin the prescribed emergency protocols (per policy), which often include continuing IV fluids, monitoring, and collecting samples for reaction testing. Administering an antipyretic or an antihistamine does not address the immediate danger of a suspected transfusion reaction, and those actions come after the transfusion has been stopped and the patient stabilized.