A client is prescribed intravenous immunoglobulin (IVIG) for Guillain-Barré Syndrome. During the infusion, the client develops a headache, chills, and muscle aches. The nurse notes the infusion rate is 100 mL/hr. Which action should the nurse take FIRST?
- ASlow the infusion rate by 50% and reassess the client.
- BObtain a blood sample for transfusion reaction workup.
- CStop the infusion immediately and notify the provider.
- DAdminister an ordered antihistamine and continue the infusion.
Show answer & explanationAnswer & explanation
Correct answer: A. Slow the infusion rate by 50% and reassess the client.
Headache, chills, and muscle aches are common, self-limiting adverse reactions to IVIG, often related to the infusion rate. The initial action is to slow the infusion rate to allow the client to tolerate the infusion better. If symptoms persist or worsen, then further interventions like stopping the infusion and notifying the provider would be necessary.
Why the other options are wrong
- B. These symptoms are typically not indicative of a blood transfusion reaction (which IVIG is not) but rather an infusion-related reaction to the IVIG itself.
- C. Stopping the infusion is appropriate for severe reactions (e.g., anaphylaxis), but these milder symptoms often respond to slowing the rate.
- D. While antihistamines may be ordered, the first action for rate-related symptoms is to adjust the rate.
IVIG Infusion Reactions
Intravenous immunoglobulin (IVIG) infusions can cause infusion-related reactions, including headache, chills, and muscle aches. These reactions are often milder than anaphylaxis and are frequently associated with the infusion rate. Slowing the rate can often mitigate these symptoms.
- Common IVIG side effects.
- Often rate-dependent.
- Symptoms: headache, chills, myalgia.
- Slow infusion rate first.
Memory trick: IVIG chills? Slow the drip!