Anemia is a symptom of an underlying condition, such as loss of blood components, inadequate elements, or lack of required nutrients for the formation of blood cells, that results in decreased oxygen-carrying capacity of the blood.
There are numerous types of anemias with various causes. The following types of anemia are discussed here: iron deficiency (ID), the result of inadequate absorption or excessive loss of iron; pernicious (PA), the result of a lack of the intrinsic factor essential for the absorption of vitamin B12; aplastic, due to failure of bone marrow; and hemolytic, due to red blood cell (RBC) destruction.
Nursing care for the anemic patient has a common theme even though the medical treatments vary widely.
Nursing Care Plan for Anemia
Nursing Care Plan for Anemia; this is a sample of nursing care plan for anemic patients (Iron Deficiency, Pernicious, Aplastic, Hemolytic).
Nursing Care Plan for Anemia: Nursing Priorities & Discharge Goals
Nursing Priorities | Nursing Care Plan for Anemia
- Enhance tissue perfusion.
- Provide nutritional/fluid needs.
- Prevent complications.
- Provide information about disease process, prognosis, and treatment regimen.
Discharge Goals | Nursing Care Plan for Anemia
- ADLs met by self or with assistance of others.
- Complications prevented/minimized.
- Disease process/prognosis and therapeutic regimen understood.
- Plan in place to meet needs after discharge.
Nursing Care Plan for Anemia: Nursing Diagnosis
Nursing Care Plan for Anemia | Nursing Diagnosis of Anemia
Nursing Care Plan for Anemia: Nursing Intervention & Rationale
Nursing Interventions of Anemia with Rationale
Energy Management (NIC)
Nursing Interventions of Anemia with Rationale: Independent
- Assess patient’s ability to perform normal tasks/ADLs, noting reports of weakness, fatigue, and difficulty accomplishing tasks. Rationale: Influences choice of interventions/needed assistance.
- Note changes in balance/gait disturbance, muscle weakness. Rationale: May indicate neurological changes associated with vitamin B12 deficiency, affecting patient safety/risk of injury.
- Monitor BP, pulse, respirations during and after activity. Note adverse responses to increased levels of activity(e.g., increased heart rate [HR]/BP, dysrhythmias, dizziness, dyspnea, tachypnea, cyanosis of mucous membranes/nailbeds). Rationale: Cardiopulmonary manifestations result from attempts by the heart and lungs to supply adequate amounts of oxygen to the tissues.
- Recommend quiet atmosphere; bedrest if indicated. Stress need to monitor and limit visitors, phone calls, and repeated unplanned interruptions. Rationale: Enhances rest to lower body’s oxygen requirements, and reduces strain on the heart and lungs.
- Elevate head of bed as tolerated. Rationale: Enhances lung expansion to maximize oxygenation for cellular uptake. Note: May be contraindicated if hypotension is present.
- Suggest patient change position slowly; monitor for dizziness. Rationale: Postural hypotension or cerebral hypoxia may cause dizziness, fainting, and increased risk of injury.
- Assist patient to prioritize ADLs/desired activities. Alternate rest periods with activity periods. Write out schedule for patient to refer to. Rationale: Promotes adequate rest, maintains energy level, and alleviates strain on the cardiac and respiratory systems.
- Provide/recommend assistance with activities/ambulation as necessary, allowing patient to do as much as possible. Rationale: Although help may be necessary, self-esteem is enhanced when patient does some things for self.
- Plan activity progression with patient, including activities that patient views as essential. Increase activity levels as tolerated. Rationale: Promotes gradual return to normal activity level and improved muscle tone/stamina without undue fatigue. Increases self-esteem and sense of control.
- Identify/implement energy-saving techniques, e.g., shower chair, sitting to perform tasks. Rationale: Encourages patient to do as much as possible, while conserving limited energy and preventing fatigue.
- Instruct patient to stop activity if palpitations, chest pain, shortness of breath, weakness, or dizziness occur. Rationale: Cellular ischemia potentiates risk of infarction and excessive cardiopulmonary strain/stress may lead to decompensation/failure.
- Discuss importance of maintaining environmental temperature and body warmth as indicated. Rationale: Vasoconstriction (shunting of blood to vital organs) decreases peripheral circulation, impairing tissue perfusion. Patient’s comfort/need for warmth must be balanced with need to avoid excessive heat with resultant vasodilation (reduces organ perfusion).
Nursing Care Plan for Anemia
Energy Management (NIC)
Nursing Interventions of Anemia with Rationale: Collaborative
- Monitor laboratory studies, e.g., Hb/Hct and RBC count, arterial blood gases (ABGs). Rationale: Identifies deficiencies in RBC components affecting oxygen transport and treatment needs/response to therapy.
- Provide supplemental oxygen as indicated. Rationale: Maximizing oxygen transport to tissues improves ability to function.
- Administer as indicated:
- Colony-stimulating factors (CSFs), e.g., aldesleukin (Interleukin-2); Rationale: CSFs may be given to stimulate growth of specific blood elements.
- Whole blood/packed RBCs (PRCs), blood products as indicated. Monitor closely for transfusion reactions. Rationale: Increases number of oxygen-carrying cells; corrects deficiencies to reduce risk of hemorrhage in acutely compromised individuals. Note: Transfusions are reserved for severe blood loss anemias with cardiovascular compromise; used after other therapies have failed to restore homeostasis.
- Prepare for surgical intervention if indicated. Rationale: Bone marrow transplant may be done in presence of bone marrow failure/aplastic anemia.
Nursing Care Plan for Anemia: Overview; Nursing Care Plan for Anemia: Nursing Priorities & Discharge Goals; Nursing Care Plan for Anemia: Nursing Diagnosis; Nursing Care Plan for Anemia: Nursing Intervention with Rationale. Nursing Care Plan for Anemia.