Questions: 1 pts You are the provider for a patient who presents with hemolytic anemia and splenomegaly, the treatment plan included a splenectomy to improve their anemia. What is most concerning regarding the patient's new condition of living without a spleen? Chronic pain where the spleen used to be. Infections with encapsulated organisms, such as Streptococcus pneumonice, Haemophilus influenza, Klebsiella, and Salmonella. Frequent falling. The need for a bone marrow transplant.

The answer is the second one: Infections with encapsulated organisms, such as Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella, and Salmonella.

Explanation for each option:

1. Chronic pain where the spleen used to be: While some patients may experience post-surgical pain, it is not the most concerning issue. Pain can typically be managed with appropriate pain relief measures and usually diminishes over time.

2. Infections with encapsulated organisms, such as Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella, and Salmonella: This is the most concerning issue. The spleen plays a crucial role in filtering bacteria and mounting an immune response against encapsulated organisms. Without a spleen, the patient is at a significantly increased risk of severe infections from these pathogens. Prophylactic antibiotics and vaccinations are often recommended to mitigate this risk.

3. Frequent falling: This is not directly related to the absence of a spleen. While any surgery can have complications that might affect mobility temporarily, frequent falling is not a primary concern associated with splenectomy.

4. The need for a bone marrow transplant: This is not a typical consequence of living without a spleen. Bone marrow transplants are generally considered for conditions affecting the bone marrow itself, such as certain cancers or severe blood disorders, not for the absence of a spleen.

Summary: The most concerning issue for a patient living without a spleen is the increased risk of infections with encapsulated organisms. This necessitates preventive measures such as vaccinations and possibly prophylactic antibiotics to protect the patient from severe infections.