Heparin Gone Rogue
Heparin triggers an immune response that paradoxically increases clotting.
What is Heparin-Induced Thrombocytopenia (HIT)?
This type of anemia is caused by an inability to absorb vitamin B₁₂.
What is pernicious anemia?
This inherited blood disorder results in abnormal hemoglobin production.
What is thalassemia?
This blood type is considered the universal donor for red blood cells.
What is O negative?
This transfusion reaction is caused by antibodies against donor RBCs and is the most dangerous.
What is an acute hemolytic transfusion reaction?
In HIT, platelet counts typically fall to this level or drop by ≥50% from baseline.
What is < 150,000/µL or a 50% decrease?
The problem in pernicious anemia is not diet, but the lack of this substance needed for B₁₂ absorption.
What is intrinsic factor?
Thalassemia is caused by decreased or absent production of this part of hemoglobin.
What are globin chains?
This test is performed before transfusion to determine ABO and Rh compatibility.
What is type and screen?
Fever and chills without hemolysis are hallmarks of this common reaction.
What is a febrile non-hemolytic reaction?
Despite low platelets, patients with HIT are at high risk for this dangerous complication.
What is thrombosis (clot formation)?
Pernicious anemia results from autoimmune destruction of these stomach cells.
What are parietal cells?
This lab pattern is expected in thalassemia.
What is microcytic, hypochromic anemia?
The nurse must stay with the patient for this amount of time after starting a blood transfusion.
What are the first 15 minutes?
This reaction presents with itching, hives, and flushing but usually no respiratory distress.
What is an allergic transfusion reaction?
When HIT is suspected, this common anticoagulant must be stopped immediately.
What is heparin (including LMWH)?
This lab finding is expected in pernicious anemia.
What is macrocytic anemia (↑ MCV)?
Unlike iron-deficiency anemia, iron levels in thalassemia are typically this.
What are normal or increased?
This vital sign change is often the earliest indicator of a transfusion reaction.
What is an increase in temperature (fever)?
This life-threatening reaction causes acute respiratory distress and noncardiogenic pulmonary edema.
What is TRALI (transfusion-related acute lung injury)?
This class of anticoagulants is used to treat HIT instead of heparin.
What are direct thrombin inhibitors (e.g., argatroban, bivalirudin)?
Because oral absorption is impaired, patients with pernicious anemia usually require vitamin B₁₂ by this route for life.
What are intramuscular injections?
This treatment is often required in severe thalassemia and can lead to iron overload.
What are frequent blood transfusions?
If a transfusion reaction is suspected, this is the priority nursing action.
What is stop the transfusion immediately?
This transfusion reaction results from volume overload, especially in older adults or those with heart failure.
What is TACO (transfusion-associated circulatory overload)?