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A 75 year old with a history of CHF presented to the ED with abdominal pain...

A 75 year old with a history of CHF presented to the ED with abdominal pain 5/10, BP-132/74, HR-86, RR-16, T-99.0, pulse ox 97%. Critcal lab values showed hemoglobin 6.4 and hematocrit 20.6. The patient was transfused with 2 units of packed red blood cells. When you re-assess the patient, what assessment finding would be the MOST concerning?

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Answer #1

Aneamia low haemoglobin level frequently occurs in congestive heart failure because heart has to work more to pump blood aand oxygen throughout the body. A low haemotocrit can be due to increased plasma volume or from reduced blood vell volume. The normal level should be above 40% and normal haemoglobin level should be above 11. Two units of PRBC has been given. So during the reassesment the haemoglobin level and haematocrit value should be increased.

Sometimes transfusion associated circulatory overload can occur in patients with CHF and its the most concerning one because fatigue, dizziness, low spo2 level and sometimes respiratory arrest will also occur.

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