What is Anemia?
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 five (5) nursing care plans (NCP) and nursing diagnosis for patients with anemia (aplastic, iron deficiency, cobalamin, pernicious):
Activity Intolerance: Insufficient physiologic or psychological energy to endure or complete required or desired daily activities.
May be related to
- Imbalance between oxygen supply and demand
Possibly evidence by
- Generalized weakness
- Deconditioned state
- Sedentary lifestyle
- Patient will identify factors that aggravate activity intolerance.
- Patient will report the ability to perform required activities of daily living.
- Patient will verbalize and use energy-conservation techniques.
- Patient will identify methods to reduce activity intolerance.
|Assess manifestations of activity intolerance. Tell the patient to rate perceived exertion on a 0-10 scale.||Signs of activity intolerance and decreased tissue oxygenation include dyspnea on exertion, headaches, dizziness, palpitations, and verbalization of increased exertion level (rated perceived exertion or RPE is more than 3). Patient should end or lessen the activity until signs of increased exertion are no longer present.|
|Check oximetry; inform physician 02 saturation 92% or less.||Supplementary oxygen is needed for 02 saturation 92% or less.|
|Assess risk of falling and enforce applicable strategies.||Patients may not be aware of the weakness and limitations leading to reduced strenth due to the potentially slow, progressive nature of anemia. Failure to monitor patient and lack of enforcement may lead to serious injuries and prolonged hospitalization.|
|Assess emotional response to limitations in physical activity.||Depression over the inability to perform activities can be a source of stress and frustration.|
|Encourage deep breathing tecnique and administer oxygen as prescribed.||These methods boost oxygen delivery to the tissues.|
|verbalization of feelings regarding limitations.||This helps the patient to cope. Acknowledgment that living with activity intolerance is both physically and emotionally difficult.|
|Aid in gradual increase of activities to tolerance as the patient’s strength progress.||This develops endurance while preventing problems caused by prolonged bedrest.|
|Gradually progress patient activity with the following:|
|Duration and frequency should be increased before intensity.|
|Allow time for the patient to have undisturbed rest.||Lessening any interruptions allows the patient to rest and benefit from sleep until anemia is resolved.|
|Give blood components (commonly packed RBCs) via intravenous catheter as prescribed.||This method will increase the number of RBCs circulating in the blood, which eventually increase the blood’s oxygen-carrying capacity.|
|Observe and report for any signs of transfusion reaction. Confirm type and crossmatching.||These measures lessen the risk of transporting the wrong type of blood to the patient.|
|Tell the patient that symptoms commonly are relieved and tolerance for activity increased with the treatment regimen.||Treatment may include packed RBC or erythropoietin replacement (recombinant EPO [epoetin-α]), 150 units/kg IV 3 times each week, or 600 units/kg subcutaneously once each week, or darbepoietin alfa 200 mcg every 2 weeks. Red cell production is improved through addition EPO (red blood cells are not responsive to normal EPO levels in chronic conditions.|
Iron and other supplements (cobalamine, folate) may be given to restore Hgb and depleted iron and other deficiencies if necessary. People with chronic disease, usually older individuals, may ot have regular dietary intake of these substances. Supplements will boost normal eryhtropoiesis.
Improvements in dietary intake and strength also may help reduce symptoms.
|Document response to activity.||Close monitoring will serve as a guide for optimal progression of activity.|
You may also like the following posts and care plans:
- Nursing Care Plan: The Ultimate Guide and Database – the ultimate database of nursing care plans for different diseases and conditions! Get the complete list!
- Nursing Diagnosis: The Complete Guide and List – archive of different nursing diagnoses with their definition, related factors, goals and nursing interventions with rationale.
References and Sources
Recommended journals, reference books, and interesting articles about Anemia nursing care plans:
- Black, J. M., & Hawks, J. H. (2009). Medical-surgical nursing: Clinical management for positive outcomes (Vol. 1). A. M. Keene (Ed.). Saunders Elsevier. [Link]
- Dharmarajan, T. S., Pankratov, A., Morris, E., Qurashi, S., Law, G., Phillips, S., … & Norkus, E. P. (2008). Anemia: its impact on hospitalizations and length of hospital stay in nursing home and community older adults. Journal of the American Medical Directors Association, 9(5), 354-359. [Link]
- Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2016). Nurse‘s pocket guide: Diagnoses, prioritized interventions, and rationales. FA Davis. [Link]
- Gulanick, M., & Myers, J. L. (2016). Nursing Care Plans: Diagnoses, Interventions, and Outcomes. Elsevier Health Sciences. [Link]
- Landi, F., Russo, A., Danese, P., Liperoti, R., Barillaro, C., Bernabei, R., & Onder, G. (2007). Anemia status, hemoglobin concentration, and mortality in nursing home older residents. Journal of the American Medical Directors Association, 8(5), 322-327.
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