Anemia, Anemia Nursing Diagnoses and Care Plans, and 2 Anemia Nursing Care Plan Examples

Anemia, Anemia Nursing Diagnoses and Care Plans, and Anemia Nursing Care Plan Examples

This article is about anemia, anemia nursing diagnoses and care plans, and anemia nursing care plan examples. It can be used in the creation of anemia nursing care plans for educational purposes.

Anemia

Anemia Guide: Causes, Symptoms and Treatment Options
Anemia

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.

What are the 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.

What are the symptoms of anemia?

Anemia may be linked to Anxiety

Anemia signs and symptoms vary depending on the cause and severity of anemia. Depending on the causes of your anemia, you might have no symptoms.

Signs and symptoms, if they do occur, might include:

  • Fatigue
  • Weakness
  • Pale or yellowish skin
  • Irregular heartbeats
  • Shortness of breath
  • Dizziness or lightheadedness
  • Chest pain
  • Cold hands and feet
  • Headaches

At first, anemia can be so mild that you don’t notice it. But symptoms worsen as anemia worsens.

What are the causes of anemia?

Anemia can be due to a condition present at birth (congenital) or to a condition you develop (acquired). Anemia occurs when your blood doesn’t have enough red blood cells.

This can happen if:

  • Your body doesn’t make enough red blood cells
  • Bleeding causes you to lose red blood cells more quickly than they can be replaced
  • Your body destroys red blood cells

What is the function of red blood cells?

Your body makes three types of blood cells — white blood cells to fight infection, platelets to help your blood clot, and red blood cells to carry oxygen from your lungs to the rest of your body and carbon dioxide from the body back to the lungs.

Red blood cells contain hemoglobin — an iron-rich protein that gives blood its red color. Hemoglobin enables red blood cells to carry oxygen from your lungs to all parts of your body and to carry carbon dioxide from other parts of the body to your lungs to be exhaled.

Most blood cells, including red blood cells, are produced regularly in your bone marrow — a spongy material found within the cavities of many of your large bones. To produce hemoglobin and red blood cells, your body needs iron, vitamin B-12, folate and other nutrients from the foods you eat.

What are the causes of different types of anemia?

Different types of anemia have different causes. They include:

  • Iron deficiency anemia. This most common type of anemia is caused by a shortage of iron in your body. Your bone marrow needs iron to make hemoglobin. Without adequate iron, your body can’t produce enough hemoglobin for red blood cells.

    Without iron supplementation, this type of anemia occurs in many pregnant women. It’s also caused by blood loss, such as from heavy menstrual bleeding; an ulcer in the stomach or small bowel; cancer of the large bowel; and regular use of some pain relievers that are available without a prescription, especially aspirin, which can cause inflammation of the stomach lining resulting in blood loss. It’s important to determine the source of iron deficiency to prevent recurrence of the anemia.

  • Vitamin deficiency anemia. Besides iron, your body needs folate and vitamin B-12 to produce enough healthy red blood cells. A diet lacking in these and other key nutrients can cause decreased red blood cell production. Some people who consume enough B-12 aren’t able to absorb the vitamin. This can lead to vitamin deficiency anemia, also known as pernicious anemia.
  • Anemia of inflammation. Certain diseases — such as cancer, HIV/AIDS, rheumatoid arthritis, kidney disease, Crohn’s disease and other acute or chronic inflammatory diseases — can interfere with the production of red blood cells.
  • Aplastic anemia. This rare, life-threatening anemia occurs when your body doesn’t produce enough red blood cells. Causes of aplastic anemia include infections, certain medicines, autoimmune diseases and exposure to toxic chemicals.
  • Anemias associated with bone marrow disease. A variety of diseases, such as leukemia and myelofibrosis, can cause anemia by affecting blood production in your bone marrow. The effects of these types of cancer and cancer-like disorders vary from mild to life-threatening.
  • Hemolytic anemias. This group of anemias develops when red blood cells are destroyed faster than bone marrow can replace them. Certain blood diseases increase red blood cell destruction. You can inherit a hemolytic anemia, or you can develop it later in life.
  • Sickle cell anemia. This inherited and sometimes serious condition is a hemolytic anemia. It’s caused by a defective form of hemoglobin that forces red blood cells to assume an abnormal crescent (sickle) shape. These irregular blood cells die prematurely, resulting in a chronic shortage of red blood cells.

What are the risk factors of anemia?

These factors place you at increased risk of anemia:

  • A diet lacking in certain vitamins and minerals. A diet consistently low in iron, vitamin B-12, folate and copper increases your risk of anemia.
  • Intestinal disorders. Having an intestinal disorder that affects the absorption of nutrients in your small intestine — such as Crohn’s disease and celiac disease — puts you at risk of anemia.
  • Menstruation. In general, women who haven’t had menopause have a greater risk of iron deficiency anemia than do men and postmenopausal women. Menstruation causes the loss of red blood cells.
  • Pregnancy. Being pregnant and not taking a multivitamin with folic acid and iron, increases your risk of anemia.
  • Chronic conditions. If you have cancer, kidney failure or another chronic condition, you could be at risk of anemia of chronic disease. These conditions can lead to a shortage of red blood cells.

    Slow, chronic blood loss from an ulcer or other source within your body can deplete your body’s store of iron, leading to iron deficiency anemia.

  • Family history. If your family has a history of an inherited anemia, such as sickle cell anemia, you also might be at increased risk of the condition.
  • Other factors. A history of certain infections, blood diseases and autoimmune disorders increases your risk of anemia. Alcoholism, exposure to toxic chemicals and the use of some medications can affect red blood cell production and lead to anemia.
  • Age. People over age 65 are at increased risk of anemia.

What will occur if anemia goes untreated?

Left untreated, anemia can cause many health problems, such as:

  • Extreme fatigue. Severe anemia can make you so tired that you can’t complete everyday tasks.
  • Pregnancy complications. Pregnant women with folate deficiency anemia can be more likely to have complications, such as premature birth.
  • Heart problems. Anemia can lead to a rapid or irregular heartbeat (arrhythmia). When you’re anemic your heart pumps more blood to make up for the lack of oxygen in the blood. This can lead to an enlarged heart or heart failure.
  • Death. Some inherited anemias, such as sickle cell anemia, can lead to life-threatening complications. Losing a lot of blood quickly results in acute, severe anemia and can be fatal. Among older people, anemia is associated with an increased risk of death.

Anemia Nursing Diagnoses and Care Plans

Anemia Nursing Diagnoses and Care Plans

How do you diagnose and care for Anemia?

Nursing care plans for clients with anemia include: assessment of risk factors, assessment of fatigue, maintenance of adequate nutrition, maintenance of adequate tissue perfusion, and compliance with the prescribed treatment regimen.

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
  • Decreased hemoglobin and diminished oxygen-carrying capacity of the blood.

What are the signs and symptoms of fatigue?

  • Exertional discomfort or dyspnea.
  • Inability to maintain usual level of physical activity.
  • Increased rest requirements.
  • Report of fatigue and lack of energy.

What are the desired outcomes for nursing diagnosis of fatigue?

  • 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.

What are the nursing assessments and rationales for fatigue?

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.

What are the nursing interventions and rationales for fatigue?

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.

Anemia Nursing Care Plan Examples

Activity Intolerance

#1 Activity Intolerance related to anemia and decreased oxygen carrying capacity of blood due to decreased RBC’s.

Hgb and Hct level are normal and the patient perceives exertion at less that 3 on a scale of 1-10, tolerates activity, AEB resp rate 12-18 breaths per minute and heart rate 60-90 beats per minute. Denies any dizziness.

Interventions Rationales
Assess for signs of activity intolerance. Ask client to rate perceived exertion. Dyspnea on exertion, palpitations, headaches, or dizziness or patient states increased exertion level, are all signs of activity intolerance and decreased tissue oxygenation.
Monitor pulse oximetry and report O2 saturation <92%. O2 sat of <92% indicates the need to supplement oxygen.
Encourage deep breathing exercises and administer oxygen if indicated Increases oxygen delivery to the body.
Assess the need for fall risk precautions. Client may not be able to perceive weakness and loss of balance.

Decreased Cardiac Output

#2 Decreased cardiac output related to inadequate RBC’s pumped by the heart to meet the oxygen needs of the tissues.

Desired Outcomes:

The client will maintain a heart rate within 60-100 bpm and maintain a blood pressure within predetermined limits.

Interventions Rationals
Interventions Rationales
Assess client q4h for increasing heart rate, increased blood pressure, fatigue or chest pressure/pain. one or all of these symptoms may indicate the beginning of cardiac failure or other complications.
Monitor pulse oximetry and report O2 saturation <92%. O2 sat of <92% indicates the need to supplement oxygen in the myocardium.
Inspect legs and feet q 4-6 hours This assesses for pedal edema and may be a sign of decreased cardiac output.
Measure and chart Intake and output q shift. Decreased urine output may be a sign of decreased renal perfusion from a decreased in cardiac output.

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 adults. Journal of the American Medical Directors Association9(5), 354-359.
  5. Eichner, E. R. (2001). Fatigue of anemia. Nutrition 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 safety. Revista 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 relationship. Revista brasileira de hematologia e hemoterapia33, 90-92.
  12. Walter, T., Olivares, M., Pizarro, F., & Muñoz, C. (1997). Iron, anemia, and infection. Nutrition Reviews55(4), 111-124.
  13. Williams, L. S., & Hopper, P. D. (2015). Understanding medical surgical nursing. FA Davis.

Anemia, Anemia Nursing Diagnoses and Care Plans, and Anemia Nursing Care Plan Examples

Anemia-Anemia-Nursing-Diagnoses and Care Plans, and Anemia Nursing Care Plan Examples

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