A nurse is assessing a client for signs of an allergic reaction to a blood transfusion. Which finding is most concerning?

In the context of assessing a client for signs of an allergic reaction to a blood transfusion, urticaria, commonly known as hives, is indeed a concerning finding. Urticaria indicates an immune response to the transfused blood, often associated with allergic reactions. This type of hypersensitivity can manifest as skin reactions but may also precede more serious consequences if the reaction escalates.

In terms of clinical importance, increased pulse rate and decreased blood pressure are also significant indicators that might suggest circulatory or cardiovascular issues. However, urticaria specifically points to an allergic response and should not be overlooked, as it can signal the potential for more severe reactions like anaphylaxis. Additionally, a normal temperature (98.6°F) is not indicative of an allergic reaction and typically does not raise concern.

Monitoring for urticaria during a blood transfusion is critical, as it can lead to a more severe allergic reaction if not addressed promptly. Therefore, the presence of urticaria is most concerning in this scenario, signaling the need for immediate assessment and intervention.