Thalassemia

Thalassemia is an inherited disorder of globin production. The affected chain may be alpha or beta, but the bedside consequence follows the same pattern: too little usable hemoglobin, ineffective red-cell production, ongoing hemolysis, and chronic anemia. Transfusions improve oxygen delivery; repeated transfusions also introduce iron, which can injure the heart, liver, and endocrine organs. The treatment plan therefore has two linked goals: maintain adequate hemoglobin and prevent iron-mediated organ damage. The RN's first task is to recognise which problem is present now. Stable pallor and microcytosis may reflect the patient's baseline disease. New dyspnea, chest discomfort, hypotension, reduced urine output, jaundice, or altered mental status suggests acute deterioration and requires a different response. A low MCV alone does not justify iron therapy: thalassemia trait and iron-deficiency anemia can look alike on a CBC, but unnecessary iron adds to the overload burden.