Activity intolerance r/t imbalance between oxygen supply and

demand secondary to anemia AEB lethargy and weakness

1. Discuss with patient the need for activity to communicate to patient that
activity will improve physical and psychosocial well-being.
2. Identify and minimize factors that decrease the patient’s exercise tolerance to
help increase the activity level.
3. Support and encourage activity to patient’s level of tolerance to help patient
develop independence.

Fear r/t ability to live with serious disease secondary to thalassemia AEB
verbalizing worry of his condition--"baka mamatay ako agad, paano na sila mama?"
1. Open up about your awareness of the patient’s fear. This approach validates the
feelings the patient is holding and demonstrates recognition of those feelings.
2. Tell patient that fear is a normal and appropriate response to circumstances in
which pain, danger, or loss of control is anticipated or felt. This reassurance
places fear within the field of normal human experiences.
3. If patient’s fear is a reasonable response, empathize with him or her. Avoid
false reassurances and be truthful. Reassure patients that asking for help is both
a sign of strength and a step toward resolution of the problem.

Risk for Infection r/t inadequate secondary defenses: immunosuppression secondary

to thalassemia
1. Monitor white blood count (WBC). Rising WBC indicates body's efforts to combat
pathogens; normal values: 4000 to 11,000.
2. Assess nutritional status, including weight, history of weight loss, and serum
albumin. Patients with poor nutritional status may be anergic, or unable to muster
a cellular immune response to pathogens and are therefore more susceptible to
infection.
3. Limit visitors. To reduce the number of organisms in patient's environment and
restrict visitation by individuals with any type of infection to reduce the
transmission of pathogens to the patient at risk for infection.

IRON CHELATION:
A cardinal rule of iron chelation therapy was established by Modell and her
colleagues in the 1970s and reiterated in the 1990s. (source:
https://ashpublications.org/blood/article/111/2/483/103696/Oral-iron-chelation-new-
drug-old-rules)

In the 1950s, Norman Clarke, Sr. was treating workers at a battery factory for lead
poisoning when he noticed that some of his patients had improved angina pectoris
following chelation therapy.[18] Clarke subsequently administered chelation therapy
to patients with angina pectoris and other occlusive vascular disease and published
his findings in The American Journal of the Medical Sciences in December 1956.
(source: https://en.wikipedia.org/wiki/Chelation_therapy#History)