A client presents with symptoms of hemolytic anemia, including pallor, fatigue, and splenomegaly.
The nurse suspects immune-mediated hemolysis.
Which diagnostic test should the nurse prioritize to confirm this suspicion?

Choice A rationale:

Elevated bilirubin levels.

Elevated bilirubin levels are not a specific clinical manifestation of intravascular hemolysis.

Bilirubin levels may be elevated in various types of anemia, but it is not a characteristic sign of intravascular hemolysis.

Choice B rationale:

Hemoglobinuria.

Hemoglobinuria is a clinical manifestation consistent with intravascular hemolysis.

When red blood cells are destroyed within blood vessels, hemoglobin is released into the bloodstream, and it can be filtered by the kidneys and excreted in the urine, leading to hemoglobinuria.

Choice C rationale:

Splenomegaly.

Splenomegaly can occur in some types of anemia, but it is not a specific clinical manifestation of intravascular hemolysis.

It may be more commonly associated with conditions like hereditary spherocytosis or thalassemia.

Choice D rationale:

Increased ferritin levels.

Increased ferritin levels are not a specific clinical manifestation of intravascular hemolysis.

Ferritin is a marker of iron storage in the body and is not directly related to the destruction of red blood cells.

Choice A rationale:

Administering blood transfusions as ordered is a treatment for hemolytic anemia to replace the deficient red blood cells.

However, it is not a nursing intervention aimed at preventing complications; it is part of the treatment plan.

Choice B rationale:

Providing oxygen therapy as prescribed is a supportive measure to improve tissue oxygenation, which is essential in managing hemolytic anemia.

However, it is not a specific nursing intervention aimed at preventing complications; it is part of the patient's overall care.

Choice C rationale:

Monitoring for fluid and electrolyte imbalances is a crucial nursing intervention in patients with hemolytic anemia.

Hemolysis can lead to the release of hemoglobin into the bloodstream, which can, in turn, cause kidney damage and electrolyte imbalances.

Monitoring and managing these imbalances are essential in preventing complications.

Choice D rationale:

Advising the patient to avoid physical activity is not a specific nursing intervention for hemolytic anemia.

While excessive physical activity may exacerbate symptoms, it is not a primary intervention for preventing complications associated with the condition.