5 Anemia Nursing Care Plans


In this guide are five nursing diagnoses for anemia nursing care plans. Get to know the nursing assessment cues, goals, related factors, and interventions with rationale in this care plan guide.

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):

  1. Fatigue
  2. Deficient Knowledge
  3. Risk For Infection
  4. Risk For Bleeding
  5. Activity Intolerance


Nursing Diagnosis

  • Fatigue
  • 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.

Desired Outcomes

  • 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.


Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023
The definitive guide to nursing diagnoses as reviewed and approved by the NANDA International. In this new version of a pioneering text, all introductory chapters have been rewritten to provide nurses with the essential information they need to comprehend assessment, its relationship to diagnosis and clinical reasoning, and the purpose and application of taxonomic organization at the bedside. A total of 46 new nursing diagnoses and 67 amended nursing diagnostics are presented.

Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
We love this book because of it’s evidence-based approach to nursing interventions. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Includes step-by-step instructions show how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking.

Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition)
Includes over two hundred care plans that reflect the most recent evidence-based guidelines. New to this edition are ICNP diagnoses, care plans on LGBTQ health issues and on electrolytes and acid-base balance.

Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales
Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The sixteenth edition includes the most recent nursing diagnoses and interventions from NANDA-I 2021-2023 and an alphabetized listing of nursing diagnoses covering more than 400 disorders.

Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care 
Identify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Only in the Nursing Diagnosis Manual will you find for each diagnosis…. subjectively and objectively – sample clinical applications, prioritized action/interventions with rationales – a documentation section, and much more!

All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health 
Includes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Interprofessional “patient problems” focus familiarizes you with how to speak to patients.

See also

Other recommended site resources for this nursing care plan:

Other care plans for hematologic and lymphatic system disorders:

References and Sources

Recommended journals, reference books, and interesting articles about Anemia nursing care plans:

  1. Badireddy, M., Baradhi, K. M., & Wilhite Hughes, A. (2021). Chronic Anemia (Nursing).
  2. Butcher, H. K., Bulechek, G. M., Dochterman, J. M. M., & Wagner, C. M. (2018). Nursing interventions classification (NIC)-E-Book. Elsevier Health Sciences.
  3. DeWit, S. C., Stromberg, H., & Dallred, C. (2016). Medical-surgical nursing: concepts & practice. Elsevier Health Sciences.
  4. 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 adultsJournal of the American Medical Directors Association9(5), 354-359.
  5. Eichner, E. R. (2001). Fatigue of anemiaNutrition reviews59(1), S17.
  6. Hinkle, J. L., & Cheever, K. H. (2018). Brunner and Suddarth’s textbook of medical-surgical nursing. Wolters kluwer india Pvt Ltd.
  7. 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 safetyRevista gaucha de enfermagem40.
  8. 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 medicine8(6), 1144-1149.
  9. 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.
  10. 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 practitioners22(1), 3-16.
  11. Viana, M. B. (2011). Anemia and infection: a complex relationshipRevista brasileira de hematologia e hemoterapia33, 90-92.
  12. Walter, T., Olivares, M., Pizarro, F., & Muñoz, C. (1997). Iron, anemia, and infectionNutrition Reviews55(4), 111-124.
  13. Williams, L. S., & Hopper, P. D. (2015). Understanding medical surgical nursing. FA Davis.

Paul Martin is a registered nurse with a bachelor of science in nursing since 2007. Having worked as a medical-surgical nurse for five years, he handled different kinds of patients and learned how to provide individualized care to them. Now, his experiences working in the hospital is carried over to his writings to help aspiring students achieve their goals. He is currently working as a nursing instructor and have a particular interest in nursing management, emergency care, critical care, infection control, and public health. As a writer at Nurseslabs, his goal is to impart his clinical knowledge and skills to students and nurses helping them become the best version of themselves and ultimately make an impact in uplifting the nursing profession.
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  • “Oxygen saturation should be kept at 90% or greater.”
    In anemic conditions Hgb will be 100% saturated, there’s just not enough RBCs to effeciently exchange gas. RR/SOB is a better better VS indicator for anemia

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