ALL INDIA INSTITUTE OF MEDICAL SCIENCES JODHPUR

COLLEGE OF NURSING
PRACTICE TEACHING
SUBJECT : -PEDIATRIC NURSING
UNIT :-
TOPIC : - ANEMIA

SUBMITTED BY SUBMITTED TO
MANEESH Mrs. REMIYA MOHAN
M.SC. NURSING 1ST YEAR LECTURER, CON
AIIMS JODHPUR

SUBMITTED ON

1
Basic Lesson Plan information:

 Subject: Pediatric nursing

 Name of the Topic- Anemia
 Name of the student teacher- Mr. Maneesh
 Name of the Supervisor- Ms. Remiya Mohan
 Date & Time of teaching-
 Venue of the teaching- LT-III
 Group of students- Bsc(H) nursing students
 Size of group- 50 students
 Method of teaching- teaching cum discussion
 Duration- one hour
 AV aids- PPT

Previous knowledge: -Group has some knowledge about the anemia

General objective: -At the end of the topic/class, students will be able to acquire knowledge about anemia.

Specific Objective: -At the end of the teaching, students will be able to-

 Define the anemia

 Discuss the classification of anemia
 Enumerate the Pathophysiology of sickle cell anemia
 Explain the clinical manifestation of anemia
 Describe the diagnosis and management of anemia
 Discuss the nursing management and nursing diagnosis of anemia.

2
S.N CONTENS PAGE NO.

1 Introduction 4
2 Definition 4
3 Classification 4
4 Heamolytic anemia 5
5 Hemorrhagic anemia 5-6
6 Iron deficiency anemia 6-8
7 Other nutritional deficiency anemia 9-10
8 Clinical manifestation 9-10
9 Diagnosis 10
10 Aplastic anemia 11
11 Sickle cell anemia
12 Nursing diagnosis
13 Conclusion
14 Research update

15 Bibliography

3
S. TIME SPECIFIC CONTENT AV METHOD EVAL
N OBJECTIV AIDS OF UATI
E USE TEACHIN ON
G
2min Introduction The term anemia describes a condition in which the number of red blood cells (RBCs) or PPT Lecture What
cum is
the hemoglobin (Hgb or Hb) concentration is reduced below normal values for age. This
discussion anemi
1 diminishes the oxygen carrying capacity of the blood, causing a reduction in the oxygen a?
available to the tissues. Anemia is the most common hematologic disorder of infancy and
childhood and is not a disease itself but an indication or manifestation of an underlying
pathologic process
2 2min Definition Decrease the oxygen carrying capacity. It include decrease number of RBC, decrease PPT Lecture Defini
cum tion of
amount of hemoglobin, increase or decrease size of RBC, abnormal shape of RBC
discussion anemi
a
3 6min Classificati PPT Lecture
on of cum
anemia discussion

4
 1. Normocytic, Normochromic anemia 1.Heamorrhagic anemia
2. Microcytic, Hypochromic anemia 2. Nutritional deficiency anemia
3. Macrocytic, Normochromic anemia 3. Heamolytic anemia
4. Macrocytic, Hypochromic anemia
7 25min Iron  Anemia caused by an inadequate supply of dietary iron is the most prevalent nutritional PPT Lecture Etiolo
cum gy of
deficiency disorder in the United States and the most preventable mineral disturbance. discussion iron
anemia  The prevalence of iron-deficiency anemia has decreased during infancy in the United defici
ency
States, probably in part because of families’ participation in the Women, Infants, and anemi
Children (WIC) program, which provides iron-fortified formula for the first year of life a
and routine screening of Hgb levels during early Childhood.
 Preterm infants are especially at risk because of their reduced fetal iron supply.
 Children 12 to 36 months of age are at risk for anemia as a result of primarily cow milk
intake and not eating an adequate amount of iron-containing food
 Adolescents are also at risk because of their rapid growth rate combined with poor eating
habits, menses, obesity, or strenuous activities.
 It is the most common type of anemia in India
 Morphology of RBC - Microcytic and Hypochromic

Etiology
 Decrease intake of iron in diet
 Decrease iron absorption from GIT
 Folic acid deficiency

5
  Hookworm infestation
 Habit disorder Pica
 Preterm delivery

 Irritability and anorexia usually

Clinical
 weakness, fatigue, leg cramps, breathlessness and tachycardia
manifestatio
 Congestive cardiac failure and Spleenomegaly may occur with severe untreated anemia.
n
 Stomatitis, glossitis,
 koilonychias and platynychia are noted in severe cases

Diagnosis

 History collection A careful dietary history is important, including the type of milk and
weaning foods in infants and the use of supplements.
 Physical examination
 Complete blood count (TRBC,PCV,HB,MCV,MCH )
 Reticulocyte count (0-2%)- increase in all type of anemia
 Erythropoietin level – increase in all type of anemia
 Serum Ferrittin level – identify iron deficiency anemia
 Folic acid level
Managemen  Stool culture for hookworm

6
t
 Iron rich diet has been prescribed
 Iron supplement has been given 3-6 mg/kg/ day (tablets, syrup )
 The iron syrup has been given :-With Vitamin –C, During meal, Before meal , After meal
 The dose is 1-3 mg/kg, diluted in 150 ml of normal saline and given as slow infusion over
30-90 min.
 The total dose of parenteral iron can be calculated by the following formula:
Iron required (mg) = wt(kg) x 2.3 x (15 – patient hemoglobin in g/dl) + (500 to 1000 mg)
 Blood transfusion
 Symptomatic treatment
If the child take iron supplement than nurse should instruct the mother of child about
a. Two time brushing after taking iron syrup
b. The color of stool will be black of child who is taking iron
Daily
requirement
of iron 1.Infant ages7-12 months – 11 mg
2.Toddlers 1-3 years – 7mg , 4-8year -10mg and 9-13 year -8mg
3.Teen age boys -11 mg and teen age girls -15 mg

Nursing
1.Fatigue related to Decreased hemoglobin and diminished oxygen-carrying capacity of the
diagnosis
blood evidence by Exertional discomfort or dyspnea, Inability to maintain usual level of

7
physical activity, Increased rest requirements, Report of fatigue and lack of energy.

Nursing intervention

 Assess the specific cause of fatigue.

 Assess the client’s ability to perform activities of daily living and demand of daily
living
 Monitor hemoglobin, Hematocrete, RBC counts, and Reticulocyte counts.
 Educate energy-conservation techniques
 Instruct the client about medications that may stimulate RBC production in the bone
marrow.
 Provide supplemental oxygen therapy, as needed.
 Anticipate the need for the transfusion of packed RBCs.

2. Deficient knowledge related to Complexity of treatment, New condition or treatment,

Unfamiliarity with the disease condition evidence by Inaccurate follow-through of
instructions, Questioning members of health care team, Verbalized inaccurate information.

Intervention

 Assess current knowledge of the diagnosis, disease process, possible causative

factors, and treatment.
 Assess the client’s and family understands of the new medical vocabulary.

8
  Explain the importance of the diagnostic procedures (such as complete blood count),
bone marrow aspiration and a possible referral to a hematologist
 Explain the hematological vocabulary and the function of blood elements ,such as
WBC,RBC and platelets

3. Risk of infection related to Bone marrow malfunction, Marrow replacement with fat in
Aplastic anemia.

Intervention

 Assess for local or systemic signs of infection, such as fever, chills, swelling, pain,
and body malaise.
 Monitor WBC count
 Instruct the client to report signs and symptoms of infection immediately.
 Anticipant the need for antibiotic, antiviral, and antifungal therapy
 Instruct the client to avoid contact with people with existing infections
 If the clients is hospitalization, provide a private room for protective isolation
 Instruct the client to avoid eating raw fruits and vegetables and uncooked meat.
 Stress the importance of daily hygiene, mouth care, and perinea care.

4.Risk for bleeding related to Bone marrow malfunction, Marrow replacement with fat in
Aplastic anemia

9
 Intervention

 Assess the skin for bruises and petechiae

 Assess for any frank bleeding from the nose, gums, vagina or urinary or GIT
 Monitor platelet count.
 Consolidate laboratory blood sampling test.
 Instruct the client about bleeding precautions.
 Instruct the client in dietary modification to reduce constipation

24 3min Conclusion Anemia is disorder in which decrease oxygen carrying capacity of body. Anemia occurs PPT Lecture
cum
due to the pathological condition and it is treatable condition. Nutrition anemia due to the
discussion
deficiency of nutritional elements in diet. Sickle cell anemia is a life threading condition
and sickled shaped RBC occlusion in blood vessels that cause ischemic condition in tissues.
25 5min Research PPT Lecture
update cum
discussion

10
BIBLIOGRAPHY:-

1. J Marilyn. Huckleberry, Wilson David .Wong’s Essential of pediatric nursing: 1 st South Asia Edition. Published in India: Elsevier health Inc; 2015:
Page no-612- 615.

2. Gupte Suraj. The short textbook of Pediatrics: Edition Eleventh. Published in New Delhi: Publisher Brother’s Medical publishers (p) Ltd; 2009: Page
no.-52-57.

3. Nelson Waldo E. Textbook of pediatrics: 20th International national Edition. Published in Canada: Publisher Elsevier health Inc; Published in 2016:
Page no.139-142.

4. Datta Parull. Pediatric nursing: Edition 3rd. Publisher Jypee Brother’s Medical publishers (p) Ltd; Published in 2014: Page no.

5. Tambulwadkar R.S. Pediatric nursing: Edition 3rd.Published in Mumbai: Publisher Vora medical publication; Published in 2009: Page no.271-276.

6. Sharma Rimple. Essential Pediatric Nursing: Edition 1st. Publisher Jypee Brother’s Medical publishers (p) Ltd; Published in 2013: Page no.323-327.

11