NLE Hematologic Nursing — Bleeding, Clotting and Hematologic MalignanciesConcept Map

Concept

Bleeding and Clotting Disorders

Sub Concepts

• Thrombocytopenia
• Immune Thrombocytopenic Purpura (ITP)
• Heparin-Induced Thrombocytopenia (HIT)
• Disseminated Intravascular Coagulation (DIC)
• Hemophilia A and B

Relationship To Central

Primary category addressing hemostasis defects causing abnormal bleeding

Concept

Hematologic Malignancies

Sub Concepts

• Acute Lymphocytic Leukemia (ALL)
• Acute Myelogenous Leukemia (AML)
• Chronic Lymphocytic Leukemia (CLL)
• Chronic Myelogenous Leukemia (CML)
• Hodgkin Lymphoma
• Non-Hodgkin Lymphoma (NHL)
• Multiple Myeloma

Relationship To Central

Cancers of blood-forming organs causing marrow failure and system complications

Concept

Blood Transfusion Practice

Sub Concepts

• Administration Procedure and Verification
• Compatible Blood Products and Solutions
• Acute Hemolytic Reaction
• Febrile Non-Hemolytic Reaction
• Allergic Reactions
• Anaphylactic Reaction
• Circulatory Overload (TACO)
• Transfusion-Related Acute Lung Injury (TRALI)
• Delayed Transfusion Reactions

Relationship To Central

Critical nursing procedure for managing bleeding and hemolytic disorders; high-risk intervention requiring strict safety protocols

Concept

Nursing Interventions and Management

Sub Concepts

• Bleeding Precautions
• Infection Prevention and Management
• Pain Management
• Fluid and Electrolyte Management
• Patient and Family Education
• Monitoring for Complications
• Chemotherapy Side Effect Management

Relationship To Central

Evidence-based nursing care addressing assessment, safety, and prevention across all hematologic disorders

To

Bleeding and Clotting Disorders

From

Normal Hemostasis

Strength

strong

Relationship

Defect in any hemostasis component causes abnormal bleeding

To

Bleeding Risk Stratification

From

Thrombocytopenia

Strength

strong

Relationship

Platelet count directly correlates with bleeding severity; below 20,000/µL indicates spontaneous bleeding risk

To

Autoimmune Destruction

From

ITP

Strength

strong

Relationship

Antibodies coat platelets triggering splenic destruction

To

Trigger Events

From

DIC

Strength

strong

Relationship

Secondary disorder always initiated by sepsis, trauma, obstetric events, or malignancy

To

Laboratory Findings

From

DIC Pathophysiology

Strength

strong

Relationship

Microthrombi consumption causes low platelets, low fibrinogen, prolonged PT/aPTT, elevated D-dimer

To

X-Linked Inheritance

From

Hemophilia

Strength

strong

Relationship

Males affected as hemizygous; females as carriers

To

Factor VIII Deficiency

From

Hemophilia A

Strength

strong

Relationship

Most common form (80% of cases)

To

Factor IX Deficiency

From

Hemophilia B

Strength

strong

Relationship

Christmas disease; also X-linked but less common

To

Hemophilia Hallmark

From

Hemarthrosis

Strength

strong

Relationship

Joint bleeding is characteristic manifestation requiring RICE and pain management

To

Marrow Failure Triad

From

Leukemia

Strength

strong

Relationship

Malignant blasts crowd out normal hematopoiesis causing anemia, infection, and bleeding

To

Fatigue and Dyspnea

From

Anemia in Leukemia

Strength

strong

Relationship

Direct consequence of reduced RBC production from marrow failure

To

Infection Risk

From

Neutropenia in Leukemia

Strength

strong

Relationship

Leading cause of death in leukemia patients; requires protective isolation

To

Bleeding Precautions

From

Thrombocytopenia in Leukemia

Strength

strong

Relationship

Mandates soft toothbrush, electric razor, no NSAIDs/aspirin, no IM injections

To

Pediatric Hematologic Malignancy

From

ALL

Strength

moderate

Relationship

Most common leukemia in children with generally good treatment response

To

Adult Hematologic Malignancy

From

AML

Strength

moderate

Relationship

Most common acute leukemia in adults requiring intensive chemotherapy

To

Philadelphia Chromosome

From

CML

Strength

strong

Relationship

Pathognomonic finding associated with tyrosine kinase inhibitor response

To

Reed-Sternberg Cells

From

Hodgkin Lymphoma

Strength

strong

Relationship

Pathognomonic histologic finding on biopsy defining the disease

To

Orderly Spread Pattern

From

Hodgkin Lymphoma

Strength

strong

Relationship

Spreads contiguously from one lymph node region to adjacent regions

To

Widespread Disease

From

Non-Hodgkin Lymphoma

Strength

strong

Relationship

Typically presents with multiple non-contiguous node involvement

To

Advanced Lymphoma

From

B Symptoms

Strength

strong

Relationship

Fever, night sweats, weight loss indicate advanced disease and worse prognosis

To

Plasma Cell Proliferation

From

Multiple Myeloma

Strength

strong

Relationship

Malignant plasma cells produce monoclonal immunoglobulin (M protein)

To

Myeloma Manifestations

From

CRAB Criteria

Strength

strong

Relationship

Diagnostic and prognostic criteria defining disease severity and complications

To

Bone Destruction

From

Hypercalcemia in Myeloma

Strength

strong

Relationship

Malignant plasma cells produce cytokines causing osteoclast activation and bone lysis

To

Renal Failure in Myeloma

From

Bence Jones Proteinuria

Strength

strong

Relationship

Light chain protein precipitates in renal tubules causing kidney dysfunction

To

Myeloma Nursing Priority

From

Hydration

Strength

strong

Relationship

Critical intervention to prevent kidney damage and manage hypercalcemia; 3-4 L/day standard

To

Myeloma Prevention

From

Mobility

Strength

strong

Relationship

Prevents complications of hypercalcemia, bone disease, and renal failure

To

Safe Nursing Practice

From

Blood Transfusion

Strength

strong

Relationship

Requires strict two-identifier verification, informed consent, and vigilant monitoring

To

Transfusion Safety

From

Verification Process

Strength

strong

Relationship

Double-checking patient identity, blood type, crossmatch, and expiration prevents wrong-unit transfusion

To

Transfusion Administration

From

Compatible IV Solution

Strength

strong

Relationship

Only normal saline compatible; dextrose causes RBC hemolysis and lactated Ringer's triggers clotting

To

Reaction Detection

From

Slow Initial Rate

Strength

strong

Relationship

Starting at 2 mL/min and remaining with patient first 15 minutes enables early recognition

To

ABO Incompatibility

From

Acute Hemolytic Reaction

Strength

strong

Relationship

Most dangerous reaction; usually from identification error resulting in fever, shock, hemoglobinuria

To

Most Common Transfusion Event

From

Febrile Non-Hemolytic Reaction

Strength

strong

Relationship

Antibodies to donor leukocytes cause fever without hemolysis; prevented by leukocyte reduction

To

IgA Deficiency

From

Anaphylactic Transfusion Reaction

Strength

strong

Relationship

IgA-deficient recipients exposed to IgA in donor plasma develop severe, life-threatening reaction

To

Circulatory Overload

From

TACO

Strength

strong

Relationship

Excess volume too rapidly administered especially in elderly and cardiac patients

To

Stop Transfusion

From

Immediate Reaction Management

Strength

strong

Relationship

First action for any suspected reaction; keep line open with normal saline via new tubing

To

Transfusion Reaction

From

Notification Requirement

Strength

strong

Relationship

Provider and blood bank must be notified immediately for investigation

To

Platelet and Clotting Disorders

From

Bleeding Precautions

Strength

strong

Relationship

Universal nursing intervention across thrombocytopenia, ITP, DIC, and hemophilia

To

Oral Bleeding Prevention

From

Soft Toothbrush

Strength

moderate

Relationship

Reduces mucosal trauma in patients with low platelets or bleeding disorders

To

Platelet Function Preservation

From

No Aspirin or NSAIDs

Strength

strong

Relationship

These drugs inhibit platelet aggregation worsening bleeding tendency

To

Neutropenic and Immunocompromised

From

Infection Prevention

Strength

strong

Relationship

Critical nursing intervention for leukemia, lymphoma, and post-chemotherapy patients

To

Infection Risk Assessment

From

ANC Monitoring

Strength

strong

Relationship

Absolute neutrophil count below 500/µL indicates high infection risk requiring protective measures

To

Emergent Response

From

Fever in Neutropenia

Strength

strong

Relationship

Single fever spike in neutropenic patient is medical emergency requiring immediate provider notification

To

Multiple Myeloma

From

Pain Management

Strength

strong

Relationship

Bone pain and hemarthrosis require comprehensive analgesic and non-pharmacologic approaches

To

Hemophilia Joint Bleed

From

RICE Protocol

Strength

strong

Relationship

Rest, ice, compression, elevation are first-aid measures for hemarthrosis

To

Hemophilia Patient Education

From

Factor Self-Infusion

Strength

strong

Relationship

Empowers patients to manage disease and reduce joint damage through prompt factor replacement

To

Leukemia and Lymphoma Care

From

Chemotherapy Management

Strength

strong

Relationship

Nursing support for nausea, mucositis, tumor lysis syndrome, and marrow suppression complications

To

Aggressive Hydration Requirement

From

Tumor Lysis Syndrome

Strength

strong

Relationship

Cell death releases intracellular contents causing hyperuricemia, hyperkalemia, hypocalcemia; requires 3-4 L/day fluids

To

Blood Transfusion Safety

From

RA 9173 Nursing Practice Law

Strength

moderate

Relationship

Philippine nursing regulation mandates safe transfusion practice within scope of nursing

To

Blood Product Availability

From

Philippine Healthcare Delivery

Strength

weak

Relationship

NLE context includes understanding resource constraints and safe transfusion alternatives