Anemia is the most common hematologic disorder in which the hemoglobin level is lower than normal, reflecting the presence of a decrease in number or derangement in function of red blood cells within the circulation. As a result, the amount of oxygen delivered to body tissues is also lessened.
Anemia may be classified in many ways. In iron deficiency anemia, it is a hypochromic, microcytic type of anemia, resulting from inadequate iron supplementation, chronic blood loss seen in men and older women who have ulcers or GI tumors and younger women with heavy menstruation.
Aplastic anemia, on the other hand, is caused by damage to hematopoietic stem cells and the bone marrow. This causes a depression of all blood elements: (pancytopenia): red blood cells (anemia), white blood cells (leukopenia), and platelets (thrombocytopenia). While pernicious anemia is caused by faulty absorption of vitamin B12 from the GI tract, which is required in the production of red blood cells.
Nursing Care Plans
Nursing care plan for clients with anemia includes: assess risk factors, decrease fatigue, maintenance of adequate nutrition, maintenance of adequate tissue perfusion, compliance with prescribed treatment regimen, and be free from complications.
Here are four (4) nursing care plans (NCP) for anemia (aplastic, iron deficiency, cobalamin, pernicious):
Fatigue: An overwhelming, sustained sense of exhaustion and decreased capacity for physical and mental work at usual level.
May be related to
- Decreased hemoglobin and diminished oxygen-carrying capacity of the blood.
Possibly evidenced by
- Exertional discomfort or dyspnea.
- Inability to maintain usual level of physical activity.
- Increased rest requirements.
- Report of fatigue and lack of energy.
- Client will verbalize use of energy conservation principles.
- Client will verbalize reduction of fatigue, as evidenced by reports of increased energy and ability to perform desired activities.
|Assess the specific cause of fatigue.||The specific cause of fatigue is due to tissue hypoxia from normocytic anemia; Other related medical problems can also compromise activity tolerance.|
|Assess the client’s ability to perform activities of daily living (ADLs), and the demands of daily living,||Fatigue can limit the client’s ability to participate in self-care and perform his or her role responsibilities in family and society, such as working outside the home.|
|Assist the client in planning and prioritizing activities of daily living (ADL).||This will allow the client to maximize his/her time for accomplishing important activities. Not all self-care and hygiene activities need to be completed i the morning. Likewise, not all housework needs to be completed in one day.|
|Assist the client in developing a schedule for daily activity and rest. Stress the importance of frequent rest periods.||Energy reserves may be depleted unless the client respects the body’s need for increased rest. A plan that balances periods of activity with periods of rest can help the client complete desired activities without adding levels to fatigue.|
|Monitor hemoglobin, hematocrit, RBC counts, and reticulocyte counts.||Decreased RBC indexes are associated with decreased oxygen-carrying capacity of the blood. It is critical to compare serial laboratory values to evaluate progression or deterioration in the client and to identify changes before they become potentially life-threatening.|
|Educate energy-conservation techniques.||Clients and caregivers may need to learn skills for delegating task to others, setting priorities, and clustering care to use available energy to complete desired activities. Organization and time management can help the client conserve energy and reduce fatigue.|
|Instruct the client about medications that may stimulate RBC production in the bone marrow.||Recombinant human erythropoietin, a hematological growth factor, increases hemoglobin and decreases the need for RBC transfusions.|
|Provide supplemental oxygen therapy, as needed.||Oxygen saturation should be kept at 90% or greater.|
|Anticipate the need for the transfusion of packed RBCs.||Packed RBCs increase oxygen-carrying capacity of the blood.|
|Refer the client and family to an occupational therapist.||The occupational therapist can teach the client about using assistive devices. The therapist also can help the client and family evaluate the need for additional energy-conservation measures in the home setting.|
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Hematologic and Lymphatic Care Plans
Care plans related to the hematologic and lymphatic system:
- Anaphylactic Shock | 4 Care Plans
- Anemia | 4 Care Plans
- Aortic Aneurysm | 4 Care Plans
- Deep Vein Thrombosis | 5 Care Plans
- Disseminated Intravascular Coagulation | 4 Care Plans
- Hemophilia | 5 Care Plans
- Leukemia | 5 Care Plans
- Lymphoma | 3 Care Plans
- Sepsis and Septicemia | 6 Care Plans
- Sickle Cell Anemia Crisis | 6 Care Plans
Recommended books and resources:
- Nursing Care Plans: Diagnoses, Interventions, and Outcomes
- Nurse's Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
- Nursing Diagnoses 2015-17: Definitions and Classification
- Diagnostic and Statistical Manual of Mental Disorders (DSM-V-TR)
- Manual of Psychiatric Nursing Care Planning
- Maternal Newborn Nursing Care Plans
- Delmar's Maternal-Infant Nursing Care Plans, 2nd Edition
- Maternal Newborn Nursing Care Plans