A complete hematologic assessment addresses each of the following as indicated by the patient’s condition and orders, and compares each finding to baseline.
Anemia signs — conjunctival and nail-bed pallor, exertional fatigue, dyspnea, dizziness, and tachycardia.
Bleeding — gum bleeding, epistaxis, hematuria, melena or hematemesis, and any active or occult bleeding.
Bruising and petechiae — new or spontaneous ecchymoses or petechiae suggesting thrombocytopenia.
Clotting tendency — the signs of deep vein thrombosis or pulmonary embolism where a hypercoagulable state or immobility is present (route to Peripheral Vascular).
Infection susceptibility — fever and infection signs, particularly in immunosuppressed or neutropenic patients (route to Allergic/Immunologic).
Transfusion-related monitoring — where the patient receives blood products at home, the signs of a reaction and delayed effects per order.
Laboratory trends — hemoglobin, platelets, white count, and coagulation studies where available, correlated with the clinical picture.
The medication context — anticoagulants, antiplatelets, chemotherapy, and immunosuppressants and their hematologic effects.
Vital signs and functional tolerance as they reflect anemia and bleeding.
The patient’s adherence to bleeding and infection precautions.
