What is Anemia?
Anemia is the most common hematologic disorder. The hemoglobin level is lower than normal, reflecting a decrease in number or derangement in the function of red blood cells within the circulation. As a result, the amount of oxygen delivered to body tissues is also lessened.
Types of Anemia
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).
- 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 the prescribed treatment regimen, and be free from complications.
Here are five (5) nursing care plans (NCP) and nursing diagnoses for patients with anemia (aplastic, iron deficiency, cobalamin, pernicious):
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 understanding on the use of energy conservation principles.
- Client will verbalize reduction of fatigue, as evidenced by reports of increased energy and ability to perform desired activities.
Nursing Assessment and Rationales
1. Assess the specific cause of fatigue.
The specific cause of fatigue is tissue hypoxia from normocytic anemia; Other related medical problems can also compromise activity tolerance.
2. 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 their role responsibilities in family and society, such as working outside the home.
3. Monitor hemoglobin, hematocrit, RBC counts, and reticulocyte counts.
Decreased RBC indexes are associated with the decreased oxygen-carrying capacity of the blood. It is critical to compare serial laboratory values to evaluate the client’s progression or deterioration and identify changes before they become life-threatening.
Nursing Interventions and Rationales
1. 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 rest periods can help the client complete desired activities without adding fatigue levels.
2. Educate energy-conservation techniques.
Clients and caregivers may need to learn skills for delegating tasks to others, setting priorities, and clustering care to use the available energy to complete desired activities. Organization and time management can help the client conserve energy and reduce fatigue.
3. 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.
4. Provide supplemental oxygen therapy as needed.
Oxygen saturation should be kept at 90% or greater.
5. Anticipate the need for the transfusion of packed RBCs.
Packed RBCs increase the oxygen-carrying capacity of the blood.
6. 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.
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:
- Badireddy, M., Baradhi, K. M., & Wilhite Hughes, A. (2021). Chronic Anemia (Nursing).
- Butcher, H. K., Bulechek, G. M., Dochterman, J. M. M., & Wagner, C. M. (2018). Nursing interventions classification (NIC)-E-Book. Elsevier Health Sciences.
- DeWit, S. C., Stromberg, H., & Dallred, C. (2016). Medical-surgical nursing: concepts & practice. Elsevier Health Sciences.
- 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.
- Eichner, E. R. (2001). Fatigue of anemia. Nutrition reviews, 59(1), S17.
- Hinkle, J. L., & Cheever, K. H. (2018). Brunner and Suddarth’s textbook of medical-surgical nursing. Wolters kluwer india Pvt Ltd.
- Lucena, A. D. F., Laurent, M. D. C. R., Reich, R., Pinto, L. R. C., Carniel, E. L., Scotti, L., & Hemesath, M. P. (2019). Nursing diagnosis risk for bleeding as an indicator of quality of care for patient safety. Revista gaucha de enfermagem, 40.
- Munch, T. N., Zhang, T., Willey, J., Palmer, J. L., & Bruera, E. (2005). The association between anemia and fatigue in patients with advanced cancer receiving palliative care. Journal of palliative medicine, 8(6), 1144-1149.
- Mock, V., & Olsen, M. (2003, November). Current management of fatigue and anemia in patients with cancer. In Seminars in oncology nursing (Vol. 19, pp. 36-41). WB Saunders.
- Sabol, V. K., Resnick, B., Galik, E., Gruber‐Baldini, A., Morton, P. G., & Hicks, G. E. (2010). Anemia and its impact on function in nursing home residents: What do we know?. Journal of the american academy of nurse practitioners, 22(1), 3-16.
- Viana, M. B. (2011). Anemia and infection: a complex relationship. Revista brasileira de hematologia e hemoterapia, 33, 90-92.
- Walter, T., Olivares, M., Pizarro, F., & Muñoz, C. (1997). Iron, anemia, and infection. Nutrition Reviews, 55(4), 111-124.
- Williams, L. S., & Hopper, P. D. (2015). Understanding medical surgical nursing. FA Davis.
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