A patient that is suffering from Anemia.

Anaemia may be the primary presenting illness or may occur secondary to another condition such as
cancer, chronic renal failure or an inherited disorder of haemoglobin synthesis. Anaemia may also be
acquired due to environmental, iatrogenic or nutritional factors.

Interestingly, many people are diagnosed with anaemia by chance when they seek medical advice for an
unrelated symptom or during a routine medical examination.

CLINICAL PRESENTATION

The clinical presentation of anaemia is diverse and each type of anaemia has specific attributes.
However, features common to all types include:

• tiredness and lethargy

• pallor

• breathlessness

• palpitations

• tachycardia

• dizziness, fainting and dimness of vision

• headache and lack of concentration

• angina and/or intermittent claudication.

HISTORY AND EXAMINATION

A diagnosis of anaemia requires a thorough patient assessment. A detailed history, looking at the
patient’s past and present health and lifestyle, should be undertaken. The use of medications such as
aspirin or phenytoin should be identified as these may contribute to anaemia. Assessing the person’s
social circumstances and nutritional intake is also important.

Physical examination may reveal:

• pallor of the skin and mucous membranes

• signs of complications of anaemia such as jaundice, dyspnoea and cardiac failure

• bleeding

• changes to hair and skin texture or pigmentation

• signs of underlying disease or conditions such as cancer or pregnancy.

INVESTIGATIONS/LAB RESULTS

Blood samples will be taken for FBC, haemoglobin level, MCV, MCH, ESR, PCV, serum iron and blood
film. Bone marrow aspiration is not undertaken routinely but is indicated if the anaemia is severe.

Complete Blood Count (CBC)

Anemia may first be detected when a routine test that counts the number and relative proportion of
each of the different types of cells in the blood stream, called a complete blood count (CBC), is done
during a health exam or as part of testing for other conditions. A CBC is often ordered as part of a yearly
physical exam and helps to evaluate overall health and to screen for a wide variety of disorders.

With anemia, some of the components of the CBC that may show abnormal results include:

RBC count—typically low

Hemoglobin—low

Hematocrit—low

RBC indices—these include mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and
mean corpuscular hemoglobin concentration (MCHC). They give a healthcare practitioner information
about the size of the red blood cells and the amount and concentration of hemoglobin in RBCs present
in someone's blood at that moment. For example, the size and hemoglobin concentration of RBCs can
help with diagnosing anemia because those characteristics can vary for different kinds of anemia.

TREATMENT

Treatment will depend on the cause, type and severity of anaemia. Some patients may need to be
hospitalised but most can be treated in the community with medication, lifestyle changes and health
education. The underlying cause of the anaemia must also be treated. Blood transfusions may be
needed either initially or repeatedly over a period of time. Follow-up care for all anaemic patients is
important to encourage and monitor compliance with medication and to prevent recurrence and long-
term adverse effects.

NURSING MANAGEMENT AND HEALTH PROMOTION

Patients may experience some general problems common to most anaemias in addition to those specific
to their type of anaemia. This section outlines the nursing management of general problems. The
specific problems and nursing management are discussed in subsequent sections. It is vital that the
patient is treated as an individual and that care is holistic. A nursing assessment of the patient’s
background, lifestyle, illness, needs and goals should be undertaken, after which a care plan will be
agreed.

Reference:

https://nursekey.com/nursing-patients-with-blood-disorders/

https://labtestsonline.org/conditions/anemia