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 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) and nursing diagnosis for patients with anemia (aplastic, iron deficiency, cobalamin, pernicious):
Risk For Infection
Risk for Infection: At increased risk for being invaded by pathogenic organisms.
- Bone marrow malfunction.
- Marrow replacement with fat in aplastic anemia.
Possibly evidenced by
- [not applicable].
- Client will have a reduced risk of infection as evidenced by an absence of fever, normal white blood cell count, and implementation of preventive measures such as proper hand washing.
- Client will have vital signs within the normal limit.
|Assess for local or systemic signs of infection, such as fever, chills, swelling, pain, and body malaise.||Opportunistic infections can easily develop, especially in immunocompromised clients.|
|Monitor WBC count.||A low white blood cell count (leukopenia) is a decrease in disease-fighting cells (leukocytes) in your blood. In general, for adults a count lower than 4,000 white blood cells per microliter of blood is considered a low white blood cell count.|
|Instruct the client to report signs and symptoms of infection immediately.||A simple fever is significant enough not to pay attention to. A need for antibiotic therapy may be indicated.|
|Anticipate the need for antibiotic, antiviral, and antifungal therapy.||These agents are effective against killing an infection.|
|Instruct the client to avoid contact with people with existing infections.||These can be a source of infection for the immunocompromised client. Children, 12 years of age or younger are at risk because they can be carriers of infection, especially upper respiratory infection.|
|If the client is hospitalized, provide a private room for protective isolation.||Environmental changes may be important if the absolute neutrophil count is less than 500/mm3. Protective isolation precautions may include placing the client in a private room, limiting visitors, and having all people who come in contact with the client use mask, gown, and gloves. These clients are at a significant risk for infection.|
|Instruct the client to avoid eating raw fruits and vegetables and uncooked meat.||These food items can harbor bacteria. A low bacterial diet protects the client from exposure to pathogens.|
|Stress the importance of daily hygiene, mouth care, and perineal care.||These preventive measures help avoid skin breakdown and lessen the risk of infection.|
|Teach the client and visitors the proper hand washing.||Practicing hand hygiene is an effective way to prevent infections. Washing hands can prevent the spread of germs, including those that are resistant to antibiotics.|
|Administer WBC growth factor to stimulate the production of neutrophils.||Colony-stimulating factors (CSFs), long-acting pegfilgrastim, filgrastim are medications used to stimulate the production of infection-fighting white blood cells.|
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