Care of patient with Anemia

In partial fulfillment of the requirement in NCM 221: Care of Mother and Child at Risk or with Problems (Acute & Chronic)

Submitted by Submitted to

MIRZI EVE ALEXIS PELLIRIN MRS. SHIELAMAE P. RUBIO

CHRISTINE DOLOYAYA Clinical Instructor

JONAICIE OBIAL

April 26 ,2023

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 Andres Bonifacio College
School of Nursing
College Park, Dipolog City

INSTITUTIONAL MISSION
We commit to provide affordable quality education with values in industry, intelligence, integrity and undertake relevant research and socially
responsive community service using innovative technologies.

INSTITUTIONAL VISION
A center of excellence in instruction, research, technology, extension, athletics, and the arts.

SCHOOL OF NURSING MISSION

The School of Nursing shall generate competent, safe and compassionate professional nurses committed to:

a. Practice high standards of nursing care utilizing research and evidence-based practices that are culturally appropriate and sensitive.
b. Active involvement in local, national and global issues affecting nursing, people’s health and the environment.Ongoing holistic growth and
development of the self and others.

VISION
Excellent Nursing Education

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 TABLE OF CONTENTS

I. Introduction ……………………………………………………………………………4
II. Human Anatomy ………………………………………………………………………
III. Pathophysiology………………………………………………………………………
IV. Drug Study…………………………………………………………………………….
V. NCP………………………………………………………………………………………

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 I.INTRODUCTION
Anemia is alternately defined as a reduced absolute number of circulating RBCs or a condition in which the number of RBCs (and
subsequently their oxygen-carrying capacity) is insufficient to meet physiologic needs. To produce RBCs and hemoglobin, your body needs a
consistent supply of iron and vitamins. Without that supply, your body won’t produce enough hemoglobin to properly carry oxygen to your organs. It’s
common for women to become anemic during pregnancy because they don’t have enough iron and other vitamins.
Though most commonly diagnosed by a low Hb concentration or a low hematocrit, anemia can also be diagnosed using RBC count, mean
corpuscular volume, blood reticulocyte count, blood film analysis, or Hb electrophoresis. At the population level and in clinical practice, Hb
concentration is the most common hematological assessment method used and the most common indicator used to define anemia. The critical role
of Hb to carry oxygen to the tissues explains the most common clinical symptoms of anemia, which include fatigue, shortness of breath, bounding
pulses or palpitations, and conjunctival and palmar pallor. Clinical signs medical
history are used to diagnose anemia when hematological data are unavailable, but
they are limited in their ability to detect anemia. Severe anemia (defined by WHO as
Hb <70 g/L in children under 5 years of age and Hb <80 g/L in all other age groups,
though other definitions, including Hb <50 g/L, are used) is of particular importance
clinically, as it can result in high-output heart failure and death.

Different types of anemia are:

Iron deficiency anemia- Iron deficiency anemia is a condition where a lack of iron in
the body leads to a reduction in the number of red blood cells. Iron is used to produce
red blood cells, which help store and carry oxygen in the blood. If you have fewer red
blood cells than is normal, your organs and tissues won't get as much oxygen as they
usually would. The most common symptoms of anemia are lethargy, shortness of
breath and a pale complexion.

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Vitamin Deficiency anemia- a lack of healthy red blood cells caused by lower than usual amounts of vitamin B-12 and folate. This can happen if you
don't eat enough foods containing vitamin B-12 and folate, or if your body has trouble absorbing or
processing these vitamins

Thalassemia- a blood disorder passed down through families (inherited) in which the body makes an
abnormal form or inadequate amount of hemoglobin. Hemoglobin is the protein in red blood cells that
carries oxygen. The disorder results in large numbers of red blood cells being destroyed, which leads to
anemia.
Sickle cell anemia- is an abnormal form of hemoglobin that causes the red cells to become rigid, and
sickle shaped. This is commonly called sickle cell anemia and is usually the most severe form of the
disease.
Aplastic anemia- a condition that occurs when your body stops producing enough new blood cells. The
condition leaves you fatigued and more prone to infections and uncontrolled bleeding. A rare and serious condition, aplastic anemia can develop at
any age.
Hemolytic Anemia-a blood condition that occurs when your red blood cells are destroyed faster than they can be replaced. Hemolytic anemia can
develop quickly or slowly, and it can be mild or serious.
Pernicious Anaemia-a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues.
There are many types of anemia. It is a decrease in red blood cells that occurs when the intestines cannot properly absorb vitamin B12.

Symptoms of anemia during pregnancy

 Pale skin, lips, nails, palms of hands, or underside of the eyelids
 Feeling tired
 Sensation of spinning (vertigo) or dizziness
 Labored breathing
 Rapid heartbeat (tachycardia)
 Trouble concentrating

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Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition.
Treatment for iron deficiency anemia includes taking iron supplements. Some forms are time-released. Others must be taken several times each day.
Taking iron with a citrus juice, such as orange, can help your body absorb it better. Taking antacids may make it harder for your body absorb to iron.
Iron supplements may cause nausea and cause stools to become dark greenish or black in color. They may also cause constipation.

II. Human Anatomy

Blood- A cellular component of blood consist of three primary cell types: erythrocytes, leukocytes and the thrombocytes. Blood is a constantly
circulating fluid providing the body with nutrition, oxygen, and waste removal. Blood is mostly liquid, with numerous cells and proteins suspended in it,
making blood "thicker" than pure water. The average person has about 5 liters (more than a gallon) of blood.

White blood cells -are part of the body's immune system. They help the body fight infection and other
diseases. Types of white blood cells are granulocytes (neutrophils, eosinophils, and basophils),
monocytes, and lymphocytes (T cells and B cells).

Neutrophil- Essential in preventing or limiting bacterial infection via phagocytosis. It is the most
abundant type of granulocytes and make up 40% to 70% of all white blood cells in humans. They form
an essential part of the innate immune system, with their functions varying in different animals.

Monocyte-type of leukocyte or white blood cell. They are the largest type of leukocyte in blood and can
differentiate into macrophages and monocyte derived dendritic cells. As a part of the vertebrate innate
immune system monocytes also influence adaptive immune responses and exert tissue repair
functions.

Eosinophils- sometimes called eosinophiles or, less commonly, acidophils, are a variety of white blood
cells and one of the immune system components responsible for combating multicellular parasites and certain infections in vertebrates.

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T lymphocytes -T lymphocytes are part of the immune system and develop from stem cells in the
bone marrow. They help protect the body from infection and may help fight cancer. Also called T cell
and thymocyte.
B Lymphocytes - type of white blood cell that makes antibodies. B lymphocytes are part of the
immune system and develop from stem cells in the bone marrow. Also called B cell.

Plasma cells - type of immune cell that makes large amounts of a specific antibody. Plasma cells
develop from B cells that have been activated. A plasma cell is a type of white blood cell. Also called
plasmacyte.

Platelets- are pieces of very large cells in the bone marrow called megakaryocytes. They help form
blood clots to slow or stop bleeding and to help wounds heal. Having too many or too few platelets or
having platelets that don't work as they should can cause problems.

Bone marrow- The bone is made up of compact bone, spongy bone, and bone marrow. Compact bone makes up the outer layer of the bone.
Spongy bone is found mostly at the ends of bones and contains red marrow. Bone marrow is found in the center of most bones and has many blood
vessels. There are two types of bone marrow: red and yellow. Red marrow contains blood stem cells that can become red blood cells, white blood
cells, or platelets. Yellow marrow is made mostly of fat. bone marrow contains cells that produce blood cells and platelets and it is responsible for
making billions of new blood cells each day.

Kidney- The kidneys are two bean-shaped organs that are roughly the size of a fist. A tough, fibrous renal capsule surrounds each kidney and
provides support for the soft tissue inside. Beyond that, two layers of fat serve as further protection. The adrenal glands lie on top of the kidneys.
III. Pathophysiology

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 IV. Drug Study

DRUG NAME INDICATION CONTRAINDICATION MECHANISM OF SIDE EFFECTS ADVERSE NURSING

ACTION EFFECTS RESPONSIBILITY

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IRON Used to Iron dextran is After iron dextran is Backache. difficulty with  Monitor for
DEXTRAN replenish contraindicated in injected, the moving. difficulty therapeutic
body iron patients with iron circulating iron blood in the with swallowing, effectiveness:
BRAND NAME: stores in Non- dextran dextran is removed urine. lightheadedness Anticipated
DEXFERRUM Dialysis hypersensitivity. Fatal from the plasma by when getting up
bluish color of response to
Drug Dependent- anaphylactoid reactions cells of the the fingernails, suddenly from a parenteral iron
classification: Chronic have occurred during reticuloendothelial lips, skin, palms, lying or sitting therapy is an
IRON Kidney the parenteral system, which split or nail beds. position. average weekly
REPLCAEMEN Disease administration of iron the complex into its hemoglobin rise
T PRODUCTS (NDD-CKD) dextran. These components of iron chest pain or of about 1 g/d.
patients reactions have been and dextran. The discomfort.  Periodic
50 mg/mL receiving or characterized by iron is immediately determinations
cold, clammy
not receiving sudden onset of bound to the of Hgb and Hct,
skin.dizziness,
erythropoietin respiratory difficulty available protein and reticulocyte
faintness, or.
and in and/or cardiovascular moieties to form count should be
Hemodialysis collapse hemosiderin or made.
Dependent ferritin, the  Do not take oral
(HDD-CKD) physiological forms iron
and of iron, or to a preparations
Peritoneal lesser extent to when receiving
Dialysis transferrin. This iron injections.
Dependent iron which is  Eat foods high in
(PDD-CKD) - subject to iron and vitamin
Chronic physiological C.
Kidney control replenishes  Notify physician
Disease hemoglobin and of any of the
patients depleted iron adverse effects
receiving an stores.
erythropoietin.

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DRUG NAME INDICATION CONTRAINDICATION MECHANISM OF SIDE EFFECTS ADVERSE NURSING
ACTION EFFECTS RESPONSIBILITY

Generic Name Folic acid is Hypersensitivity to folic Stimulates loss of appetite, redness,  Monitor patient
:FOLIC ACID indicated for acid. Cautions: production of for
the treatment Anemias (aplastic, platelets, nausea, skin rash,
hypersensitivity
Brand Name: of folic acid normocytic, pernicious, abdominal itching reactions,
deficiency, refractory) when WBCs in folate-
FOLVITE swelling, especially if
megaloblastic anemia present with deficiency anemia. feeling unwell, and drug previously
Classification: anemia, and vitamin B12 Necessary for gas, taken.
formation of co- difficulty breathing
in anemias of  Test using
FOLIC ACID enzymes in many bitter or bad
nutritional Schilling test
VITAMIN metabolic taste in your
origins, and serum
SUPPLEMENT, pathways. mouth,
pregnancy, vitamin B12
infancy, or Necessary for
PREGNANCY insomnia, levels to rule
childhood. erythropoiesis .Ther
CATEGORY A out pernicious
apeutic effect: difficulty anemia.
concentrating, Therapy may
Essential
nucleoprotein mask signs of
synthesis, pernicious
maintenance of anemia while
normal the neurologic
erythropoiesis deterioration
continues.
 Report rash,
difficulty

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 breathing, pain
or discomfort at
injection site..

DRUG NAME INDICATION CONTRAINDICATION MECHANISM SIDE EFFECTS ADVERSE NURSING

OF ACTION EFFECTS RESPONSIBILITY

FERROUS Haemochromatosis, Ferrous sulfate Feeling or being Gastrointestinal  Be aware that

SULFATE other iron overload facilitates sick (nausea or disorders: milk, eggs, or
Ferrous
syndromes. Blood oxygen transport vomiting) Gastrointestinal caffeine
Generic name : sulfate is
disorders (e.g. via Hb. It is used irritation, nausea, beverages
used for the Stomach
Ferrous sulfate paroxysmal nocturnal as iron source vomiting, epigastric when taken
prevention discomfort or
anhydrous haemoglobinuria, as it replaces pain, diarrhoea, with the iron
and heartburn
haemolytic anaemia, iron found in Hb, constipation, preparation
treatment of
Classifications: haemosiderosis, other myoglobin and Losing your blackening of stool, may inhibit
iron
anaemias); active other enzymes. appetite tooth discolouration, absorption.
BLOOD deficiency
peptic ulcer, regional abdominal  Be aware that
anemia in
FORMERS, enteritis and ulcerative Constipation discomfort. iron
adults and
COAGULATE, AND colitis. Patient preparations
children Diarrhoea Immune system
ANTICOAGULANTS receiving frequent cause dark
blood transfusions. disorders:
; IRON Dark or black green or black
Concomitant Hypersensitivity.
PREPARATION poo stools.
parenteral iron  Monitor Hgb
therapy. Black stained
and reticulocyte
teeth
values during

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 therapy.

DRUG NAME INDICATION CONTRAINDICATIO MECHANISM SIDE EFFECTS ADVERSE NURSING

N OF ACTION EFFECTS RESPONSIBILITY

Vitamin B12 Pernicious You should not use serves as a Dizziness severe allergic  Intensive
anemia: this medicine if you cofactor for reaction treatment of
Brand Name; Intrinsic factor are allergic to cobalt methionine Headache
B12-deficient
of Castle or if you have Leber's synthase and L- (anaphylaxis)
Classification: B cold symptoms megaloblastic
Vitamins, Vitamins, deficiency due disease. methylmalonyl- anemia may
Water-Soluble to CoA mutase skin swelling cause
autoantibody enzymes. congestive heart hypokalemia
diarrhea failure
formation Methionine and sudden
against synthase is peripheral vascular death.
parietal cells essential for the disease  Vitamin B12
of the synthesis of deficiency for
stomach, purines and over 3 months
which results pyrimidines that results in
in decreased form DNA. L- irreversible
absorption of methylmalonyl- degenerative
vitamin B12 CoA mutase central nervous
through ileum. converts L- system lesions
methylmalonyl-
Malabsorption: CoA to succinyl-
Impairment of CoA in the
vitamin B12 degradation of
absorption. propionate 24,

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 an important
reaction
required for both
fat and protein
metabolism.

V.NURSING CARE PLAN

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