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A 65-year-old client has just received 30 minutes of a packed red blood cell (PRBC) transfusion following a total hip replacement surgery. The nurse enters the room and notes that the client is flushed, shivering, and complaining of back pain and a sense of “doom.” Vital signs have changed from baseline: temperature increased from 98.4°F (36.9°C) to 101.3°F (38.5°C), HR from 88 to 120/min, BP from 132/80 to 98/60 mm Hg. Which actions should the nurse take immediately? Select all that apply.

A. Stop the transfusion and maintain a patent IV line with normal saline
B. Notify the provider and the blood bank of the suspected reaction
C. Return the blood bag and tubing to the blood bank for analysis
D. Administer acetaminophen and resume the transfusion when the fever resolves
E. Document the reaction in the client’s chart and continue close monitoring

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