Which client should the nurse practitioner recognize as most at risk for developing hemolytic anemia?

The individual who experienced a transfusion reaction after a blood transfusion is recognized as most at risk for developing hemolytic anemia because such reactions can trigger the body’s immune system to attack red blood cells. Incompatible blood transfusions often lead to hemolysis, where red blood cells are destroyed faster than they can be produced. This is particularly true if the recipient's immune system identifies the transfused blood as foreign and mounts an aggressive response against the donor's red blood cells.

The other scenarios present varying risks associated with anemia but do not specifically indicate an immediate risk for hemolytic anemia. A family history of thalassemia suggests a genetic predisposition to a form of anemia caused by the improper formation of hemoglobin, rather than the destruction of red blood cells. Recent surgery for a bleeding ulcer may result in anemia from blood loss but not directly from hemolysis. A history of iron-deficiency anemia suggests problems with red blood cell production or iron availability rather than destruction. Thus, while all these clients may have anemia, the one with a transfusion reaction directly links to hemolytic processes.