Medsurg Chapter 30

• Their RBC antigen is A
• Their Plasma/Serum Antibody is Anti-B
• Compatible donors for RBC transfusions are A and O
• Compatible donors for plasma transfusions are A and AB

• Their RBC antigen is B
• Their Plasma/Serum Antibody is Anti-A
• Compatible donors for RBC transfusions are B and O
• Compatible donors for plasma transfusions are B and AB

• Type AB is the universal recipient
• Their RBC antigens are A and B
• Their Plasma/Serum Antibody Neither Anti-A nor Anti-B
• Compatible donors for RBC transfusions are A, B, AB, and O
• Compatible donors for plasma transfusions are AB

• Type O is the universal donor
• Their RBC antigen is Neither
• Their Plasma/Serum Antibody is Anti-A and Anti-B
• Compatible donors for RBC transfusions are O
• Compatible donors for plasma transfusions are A, B, AB, and O

Description: Paleness; decreased or absence of skin coloration.

Possible Etiology: Low Hb level (anemia)

Description: Transient, episodic redness of skin (usually around face and neck).

• Possible Etiology: Increase in Hb (polycythemia), congestion of capillaries,
• Flushing of the palms of the hands or soles of the feet may indicate anemia

Description: Yellow appearance of skin and mucous membranes.

Possible Etiology: Accumulation of bile pigment caused by rapid or excessive hemolysis or liver damage.

Description: Bluish discoloration of skin and mucous membranes.

Possible Etiology: Reduced Hb, excessive concentration of deoxyHb in blood

Description: Unpleasant cutaneous sensation that provokes the desire to rub or scratch the skin

Possible Etiology: Hodgkin's lymphoma, cutaneous lymphomas, infiltration leukemias, increased bilirubin

Description: Prominent on the malleoli on the ankles

Possible Etiology: Sickle Cell disease

Description: Benign tumor consisting of blood or lymph vessels

Possible Etiology: Most are congenital; some may disappear spontaneously

Description: Small angioma with a tendency to bleed; focal red lesions, coarse or fine red lines

Possible Etiology: Dilation of small vessels

Description: Form of  of telangiectasia characterized by a round red central portion and branching radiations resembling the profile of a spider; usually develop on face, neck, or chest.

Possible Etiology: Elevated estrogen levels as in pregnancy or liver disease.

Description: Any of a small group of conditions characterized by ecchymosis or other small hemorrhages in skin and mucus membranes.

Possible Etiology: Decreased platelets or clotting factors resulting in hemorrhage into the skin; vascular abnormalities; break in blood vessel walls resulting from trauma

Description:  Pinpoint, nonraised, perfectly round area < 2 mm; purple, dark red, or brown in color.

Possible Etiology: Decreased platelets or clotting factors resulting in hemorrhage into the skin; vascular abnormalities; break in blood vessel walls resulting from trauma

Description: Small hemorrhagic spot, larger than petechiae; non-elevated; round or irregular

Possible Etiology: Decreased platelets or clotting factors resulting in hemorrhage into the skin; vascular abnormalities; break in blood vessel walls resulting from trauma

Description: A localized collection of blood, usually clotted.

Possible Etiology: Decreased platelets or clotting factors resulting in hemorrhage into the skin; vascular abnormalities; break in blood vessel walls resulting from trauma

Description: A tumor arising from myeloid tissue and containing a pale, green pigment

Possible Etiology: Acute myelogenous leukemia that has infiltrated the skin.

Description: A tumor arising from abnormal plasma cells

Possible Etiology: Multiple myeloma that has infiltrated tissue

Description: Yellow appearance of the sclera

Possible Etiology: Accumulation of bile pigment resulting from rapid or excessive hemolysis or liver disease or infiltration.

Description: Paleness; decreased or absence of coloration in the conjunctiva.

Possible Etiology: Low Hb level (anemia)

Description: Decreased visual acuity or areas of blindness (field cuts)

• Possible Etiology: Anemia, extreme leukocytosis, polycythemia may cause visual abnormalities
• Thrombocytopenia may cause intracellular hemorrhage with visual abnormalities. Excessive clotting may cause thromboses in the circulation to the brain that cause visual cuts.

Description: Spontaneous bleeding from the nares

Possible Etiology: May occur with low platelet counts, especially if the patient bends down for a long time period, tries to lift a heavy item or with an intense valsalva maneuver.

Description: Pallor, Gingival/mucosal ulceration, swelling or bleeding.

Possible Etiology: Neutropenia; inability of impaired leukocytes to combat oral infections; thrombocytopenia

Description: Tongue surface is smooth and shiny; mucosa is thin and red from decreased papillae

Possible Etiology: Pernicious anemia, iron deficiency anemia

Description: Lymph nodes are enlarged (< 1 cm), may be tender to touch

Possible Etiology: Infection, foreign infiltration, or systemic disease such as leukemia, lymphoma, Hodgkin's lymphoma and  metastatic cancer

Description: Heart Rate > 100 beats/min

Possible Etiology: Compensatory mechanism in anemia to increase cardiac output

Description: Sensation of feeling the heart beat, flutter, or pound in the chest.

Possible Etiology: Anemia, fluid volume overload, hypotension with impending syncope, and dysrhythmias cause palpitations

• Description:
•        Orthostasis: heart rate > 20 bpm increase or blood pressure > 20 mm Hg decrease from baseline when moving from a lying position to either sitting or standing.
•        Hypotension: < 90 mm Hg systolic or > 40 mm Hg drop from baseline.
•        Hypertension: > 130/90 mm Hg

Possible Etiology: Orthostasis is a common manifestation in anemia, especially if also accompanied by low blood volume

Description: Abnormal sensitivity to touch or pressure on sternum.

Possible Etiology: Leukemia resulting from increased bone marrow cellularity, causing increase in pressure and bone marrow erosion; multiple myeloma as a result of stretching of periosteum.

Description: Oxygen carrying capacity is reflected by the oxygen saturation by pulse oximetry

Possible Etiology: Oxygen saturation may be decreased in cases of severe anemia

Description: Palpable liver

Possible Etiology: Leukemia, cirrhosis, or fibrosis secondary to iron overload from sickle cell disease or thalassemia

Description: Palpable spleen

Possible Etiology: Anemia, thrombocytopenia, leukemia, lymphomas, leukopenia, mononucleosis, malaria, cirrhosis, trauma, portal hypertension

Description: Distended abdomen is a larger than normal abdominal profile. It may be soft or firm, tender or nontender, and accompanied by other symptoms such as nausea, vomiting, or rebound tenderness

Possible Etiology: Lymphoma may manifest as abdominal adenopathy, mass(es), or bowel obstruction.

Description: Numbness sensation and extreme sensitivity experienced in central and peripheral nerves; impaired muscle movement

Possible Etiology: Cobalamin (Vitamin B₁₂) deficiency or folate deficiency

Description: Lacking physical strength or energy

Possible Etiology: Low Hb level (anemia)

Description:  Pain in the cranium, potentially involving one area or extending from the frontal area to the back of the neck.

Possible Etiology: Generalized headache is a common manifestation of mild to moderate anemia. Severe headache with or without visual disturbances may signal intracranial hemorrhage due to thrombocytopenia.

Description: Pain in pelvis, ribs, spine, sternum

Possible Etiology: Multiple myeloma related to enlarged tumors that stretch periosteum; bone invasion by leukemia cells; bone demineralization resulting from various malignancies; sickle cell disease.

Description: Fluid-Filled spaces surrounding the joints

Possible Etiology: Occurs with hemophilia and sickle cell anemia as bleeding occurs into the joint (hemarthria) causing inflammation.

Description: Joint Pain

Possible Etiology: Sickle cell disease from hemarthrosis