Ohio University, AthensNURSING NR 507Discussion Part Two NR 507 advanced pathophysiology.

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Discussion Part Two (graded) A patient has been admitted into the emergency room that was in the passenger side of a car that collided with another car head on. The patient is pale, barely conscious... and has a weak and thready pulse. An IV is started. The vitals are BP 80/50, P 140, T 96.0 and R 26. As the team fights to keep the patient alive they have to remove the spleen. Blood is given but it has been mistyped. A transfusion reaction occurs. Describe the type of hypersensitivity reaction that has occurred and discuss the molecular pathophysiology of the specific type of hypersensitive reaction you have chosen. In the event that this patient survived the car accident and the transfusion reaction which organs are most likely to be damaged and why? Topic responses  Discussion  Expand All More Sort By:        Victoria Blauvelt 8/29/2016 11:35:35 PM Discussion Part Two Instructor and Class, Alloimmunity occurs when “the immune system of one individual produces an immunologic reaction against tissues of another individual,” (Goroll & Mulley, 2014, p.263). This type of reaction can be seen during transfusions, tissue transplantations, and in the fetus during pregnancy. A reaction that occurs during a blood transfusion as a result of an error in type and screen will trigger a type II hypersensitivity reaction. Red blood cells contain many antigens on their surface that are responsible for determining an individual’s blood group. ABO and Rh are the two largest blood groups and play an important role when it comes to the transfusion of blood. An individual can have one of four different blood types: A, B, AB, or O. A blood type A individual carries A antigens and also possesses antibodies to the B antigen. Blood type B individuals carry B antigens and posses antibodies to the A antigen. Blood type AB individuals carry both A and B antigens and do not posses any antibodies, allowing them to receive blood from any of the three types. Blood type O individuals carry neither A nor B antigens however carry both A and B antibodies. Blood type O individuals can donate blood to any of the three types, however they can only receive type O blood (Casey, 2011). Similar to ABO, Rh is another type of antigen found on red blood cells. A person can either be Rh-positive or Rh-negative depending on whether a person possesses the D antigen or not. In a type II hypersensitivity reaction, a specific tissue or cell is the target of an immune response. The initial process involves antibodies binding to the tissue-specific antigens and then destroying it. In a reaction during a blood transfusion antibody IgG or IgM attach to the antigen activating the complement response and creates a cascade effect (Goroll & Mulley, 2014). The membranes of the cell are damaged resulting in lysis of the cell. The patient who was involved in the car accident and had a reaction to the blood transfusion is at risk for certain organ damage. If a reaction was not quickly identified and transfusion was not immediately stopped, as well as initiating supportive treatment, then damage could be done to the both the kidneys and lungs. According to Battard Menendez (2016), potential severe complications of acute hemolytic reactions include DIC and renal failure. Transfusion related acute lung injury (TRALI) is another complication that can occur during a blood transfusion, especially in a critical patient. TRALI is a form of an acute lung injury and is an important cause of transfusion related deaths (Sahu, Hemlata, & Verma, 2014). Patient is also at risk for multiorgan damage and/or failure due to hypovolemic shock [Show More]

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