A nurse is reviewing laboratory findings for a client admitted with multiple myeloma. The nurse should expect to see an increase in which of the following laboratory tests?

Reported pain

• Leukemia: Possible, as bone pain can occur due to marrow involvement.
• Sickle Cell Anemia: Yes, common due to vaso-occlusive crises.
• Hemophilia: No, hemophilia typically causes bleeding rather than pain from blood cell abnormalities.

Bleeding

• Leukemia: Yes, due to thrombocytopenia.
• Sickle Cell Anemia: No, bleeding is not typical in sickle cell crises.
• Hemophilia: Yes, hemophilia is a bleeding disorder due to a clotting factor deficiency.

Temperature

• Leukemia: Yes, fever can indicate infection due to immunosuppression.
• Sickle Cell Anemia: Yes, fever can be a sign of infection during crises.
• Hemophilia: No, hemophilia does not cause fever unless there is an infection.

Bruising

• Leukemia: Yes, thrombocytopenia can lead to easy bruising.
• Sickle Cell Anemia: No, bruising is not typical in sickle cell crises.
• Hemophilia: Yes, due to a clotting factor deficiency, easy bruising is common.

WBC count

• Leukemia: Yes, often elevated due to immature or abnormal white cells.
• Sickle Cell Anemia: No, WBC count is usually normal unless there is an infection.
• Hemophilia: No, WBC count is typically normal in hemophilia.

A. WBCs: White blood cell counts may vary in multiple myeloma, but they are not typically increased; in fact, WBC counts can be low due to bone marrow crowding.

B. Calcium: Multiple myeloma often causes hypercalcemia because of increased bone breakdown, leading to the release of calcium into the bloodstream.

C. Absolute neutrophil count: The absolute neutrophil count may actually decrease as a result of bone marrow dysfunction, not increase.

D. Platelets: Platelet counts are often decreased in multiple myeloma due to bone marrow involvement, not increased.