The patient is showing signs and symptoms concerning for a transfusion reaction. If a transfusion reaction is clinically suspected, the first action is to stop the transfusion. Once stopped, the nurse can notify the provider for future instructions. The nurse should perform a clinical assessment of the patient, including checking for evidence of hematuria, but first the transfusion should be stopped and the provider notified. Intravenous diphenhydramine might be indicated for management of urticaria, but this decision should be deferred to the provider.