Recognition
- Jaundice from excessive RBC destruction and bilirubin buildup
- Persistent fatigue, lethargy, weakness
- Dyspnea, rapid breathing, and tachycardia (compensatory for reduced oxygen-carrying capacity)
- Pallor in skin, mucous membranes, and nail beds
- Intolerance to cold
- Splenomegaly (spleen enlarged from recycling massive volumes of defective RBCs)
- Iron overload from frequent blood transfusions can damage the liver and heart. No natural method for eliminating excess iron
- In children: misshapen bones similar to rickets. Growth retardation
MT Relevance
- Gentle, noncirculatory work is indicated. Rigorous long massage is contraindicated if the client is fragile with low stamina
- Position change caution: Alert for dizziness and weakness during table transitions. Compensatory tachycardia may be stressed by position changes
- Cold avoidance: Do not use cold applications (worsens cold intolerance). Warm applications provide comfort
- Bruising risk: If the client has iron overload-related liver dysfunction, coagulopathy may be present. Use conservative pressure
- Session length: Adapt to client tolerance. Shorter sessions may be necessary
Required Actions
- Refer for medical evaluation if an undiagnosed client presents with unexplained jaundice, persistent fatigue, and pallor
- Ask about transfusion history �� iron overload complications affect treatment planning
- Monitor for cardiovascular symptoms (arrhythmia, chest pain) as heart failure is a complication of iron overload
Key Takeaways
- Thalassemia is an inherited hemoglobin disorder producing small, pale, short-lived RBCs. Most prevalent in Mediterranean, Middle Eastern, African, and Southeast Asian descent.
- Gentle, noncirculatory work is indicated. Rigorous long massage is contraindicated if the client is fragile.
- Iron overload from frequent blood transfusions can damage the liver and heart. There is no natural method for eliminating excess iron.
- Alert for dizziness and weakness during table transitions. Avoid cold applications (worsens cold intolerance).
- Warm applications provide comfort and pain relief.