Hematologic Disorders: Leukemia, Myeloma, Transfusions & ITP

What is leukemia?

A condition characterized by bone marrow failure leading to decreased functional WBCs, platelets, and RBCs/Hgb.

What are the lab findings associated with leukemia?

Low Hgb/Hct, low platelets, and abnormal WBC counts.

What are the priorities in managing a patient with leukemia?

Protect the patient from infection and injury, manage activity for fatigue due to poor gas exchange.

What are the treatment options for leukemia?

Chemotherapy, targeted therapy, immunotherapy, and stem cell transplants.

What is multiple myeloma?

A cancer of plasma cells that secrete antibodies, more common in adults over 65, African Americans, and men.

What are the risk factors for multiple myeloma?

Chemical exposure, human herpesvirus 8, and radiation exposure.

What does CRAB stand for in multiple myeloma diagnosis?

Hypercalcemia, Renal failure, Anemia, Bone issues.

What are common diagnostic findings in multiple myeloma?

Paraprotein in serum/urine, osteolytic bone lesions, bone fractures, hypertension, infections, hypercalcemia, and fluid imbalance.

What is the treatment focus for multiple myeloma?

Pain management, monitoring for complications, addressing pancytopenia, and HSCT.

What are the pretransfusion safety steps?

Informed consent, blood type and crossmatch, use of y-tubing with NS, and verification with a second RN.

What should be monitored during a blood transfusion?

Obtain baseline vitals and assess the patient for the first 15-30 minutes for any adverse reactions.

What are the signs of an acute hemolytic reaction?

Destruction of donor cells due to antibodies, classified as Type II hypersensitivity.

What characterizes a delayed hemolytic reaction?

Delayed destruction of donor red cells, reaction with antibodies in the recipient's serum, and possible jaundice.

What are febrile reactions during transfusion?

Fever caused by recipient antibodies directed against donor's white cells.

What causes allergic reactions during blood transfusions?

Antibodies against donor proteins.

What is TRALI?

Transfusion-related acute lung injury, where neutrophils gather in the lungs causing leakage of protein and fluid into alveolar space.

What is TACO?

Transfusion-associated circulatory overload, characterized by dyspnea, tachycardia, chest pain, and swelling.

What is ITP?

An autoimmune disorder where the immune system produces antibodies against its own platelet membranes, leading to reduced circulating platelets.

What skin changes are associated with ITP?

Ecchymosis, purpura, petechia, and bleeding mucous membranes.

What are the lab findings in ITP?

Low platelets, low Hgb/Hct, and anemia if bleeding is extensive.

What are the treatment options for ITP?

Platelet transfusions, drug therapy, patient safety measures, surgical management, and infection control.