Signs and Symptoms
Fever, chills, hypotension, rash, urticaria, back pain, dyspnea
Blood Transfusion Reaction
Prolonged aPTT, normal PT, normal platelets, low Factor VIII or Factor IX
Hemophilia A & B
Normal or mildly abnormal CBC, diagnosis via lymph node biopsy, sporadic growth EVERY WHERE!!!
Non-Hodgkins Lymphoma
Treat underlying cause; iron supplementation for iron deficiency, vitamin B12 or folate if deficient, blood transfusion for severe cases
Anemia
Monitor O2 saturation, respiratory status, pain management, prevent infection, encourage incentive spirometry
Acute Chest Syndrome
Bone pain (especially back/ribs), fractures, fatigue, hypercalcemia, renal insufficiency
Multiple Myeloma
High WBC with blasts, anemia, thrombocytopenia, abnormal differential
Leukemia
Post-transplant labs: variable counts depending on engraftment, monitor for GVHD
Stem Cell Transplant
Monitor for pain crises, oxygenation, hydration status, infection prevention, patient education on triggers
Sickle Cell Disease
Verify patient ID and blood compatibility, monitor for transfusion reactions, vitals before/during/after, educate patient
Blood Transfusion
Recurrent infections, fever, malaise, sore throat, mucosal ulcers
Neutropenia
Tear-drop shaped RBCs, leukoerythroblastosis, cytopenias, marrow fibrosis on biopsy
Myelofibrosis
Prolonged PT & aPTT, low platelets, elevated D-dimer, low fibrinogen
Disseminated Intravascular Coagulation (D.I.C.)
Oral or IV iron supplementation, treat underlying cause of blood loss
Iron Deficiency Anemia
Bleeding precautions, monitor platelet count, avoid invasive procedures, educate patient on safe activities
Thrombocytopenia
Fatigue, joint pain, bronze skin, liver enlargement, diabetes, cardiomyopathy
Hemochromatosis
Platelet count >600,000/μL, may see microvascular symptoms
Thrombocythemia
hypoxia symptomsElevated RBC, Hct >55%, normal or low EPO, WBC/platelets normal
Secondary Polycythemia
Immunosuppressive therapy (antithymocyte globulin, cyclosporine), blood transfusions, stem cell transplant in severe cases
Aplastic Anemia
Monitor CBC, dietary education, assess for fatigue, teach importance of supplementation
Folate Deficiency Anemia
Headache, dizziness, ruddy complexion, pruritus (especially after warm bath), hypertension, splenomegaly
Polycythemia Vera
Hyperkalemia, hyperphosphatemia, hyperuricemia, hypocalcemia, elevated creatinine
Tumor Lysis Syndrome
Macrocytic anemia, hypersegmented neutrophils, low B12, positive intrinsic factor antibodies
Pernicious Anemia
Chemotherapy, radiation, targeted therapy (rituximab), stem cell transplant in refractory cases
Lymphoma
Monitor CBC, infection precautions, bleeding precautions, education on transfusion reactions, psychosocial support
Myelodysplastic Syndrome