ANEMIA

DEFINITION
• Anemia is a condition in which the red blood
cells count or their oxygen carrying capacity is
insufficient to meet physiologic needs,which
vary by age,sex,attitude,smoking and
pregnancy status.
• According to WHO
 PREVALENCE
• In India, more than half(51%) of all women of
reproductive age have anemia.

• 2016 – Reported 48% of women in India were

anemic
• 2017 – 27% of global population were affected
by anaemic.
 RISK FACTORS
• 1. A diet lack in vitamin and minerals B 12 and
iron and folate.
• 2.Intestinal disorder.
• 3.Menstruation.
• 4.Pregnancy.
• 5.Chronic conditions.
• 6.Family history
 TYPES/CAUSES/CF
• 1)Iron deficiency anemia
• Most common type.
• Shortage of iron in the body.
• Bonemarrow needs iron to make hemoglobin without adequate
iron, body cant produce hemoglobin for red blood cells.
• Occurs in pregnant women.
• Blood loss such as menstrual bleeding,an ulcer,cancer and
regular use of some OTC pain relievers
• Symptoms of this anemia include fatigue and
pallor in severe cases, patient may have
orthostatic changes in heart rate and blood
pressure
• Physicians treat iron deficiency anemia by
prescribing iron suplements such as ferrous
sulfate and iron dextran
• 2)Vitamin defeciency anemia(B12)/Pernicious
Anemia.
• Besides iron, body needs folate and vitamin B-
12 to produce enough healthy red blood cells.
• Malabsorption of vitamin B12 from stomach
due to lack of intrinsic factor.
• Clinical features seen in addition to are
fatigue,pallor commonly seen
• Symptoms of pernicious characteristically
include weakness,a sore tongue and
numbness of the hands and feet.
• Physicians treat pernicious anemia by
prescribing a monthly intramuscular injection
of vitamin B12.
• Nurses role is incorporating foods high in iron
in the diet.
• Aplastic anemia-
• Rare life-threatening anemia occurs when body doesn’t produce
enough red blood cells.
• Complete failure of the bone marrow.
• Patients with this condition have extremely low RBC,WBC and
platelet because their bonemarrow is not making these cells.
• Signs and symptoms include pallor, extreme
fatigue,tachycardia,shortness of breath,
unusually prolonged or spontaneous bleeding, frequent infections.
Medical treatment includes transfusions, antibiotics and bone
marrow transplant.
• 4)Autoimmune Hemolytic Anemia
• This group of anemia develops when red blood cells are
destroyed faster than bonemarrow can replace them.
• The bonemarrow makes adequate blood cells but they
are destroyed once they are released into the
circulation.
• Causes include certain infections,drug reactions and
certain cancers
• Hemolytic anemia of newborn and blood transfusions
• S/S includes pallor,extreme fatigue, tachycardia,shortness of
breath,hypotension and patient may look jaundiced.
• Medical treatment includes blood transfusion and cortico steriods.

• 5)Sickle cell Anemia-

• It is a disease in which the normally disk-shaped RBCs become
sickle shaped
• It is a genetic disease that occurs in African Americans
• 8% of Africans Americans carry this gene
• Sickle cell anemia is carried on a recessive gene, person must
inherit from the mother and father both.Sy
• Symptoms of sickle cell anemia include persistently
low RBC counts, fatigue and jaundice and
cardiomegally(in an attempt to oxygenate the body’s
tissues)
• Sickle cell crisis occurs when the sickled cells
become stuck in larger blood vessels of the body,
obstructing blood flow and causing severe
pain,circulation to the
chest,abdomen,bones,joints,bonemarrow,brain or
penis may be compromised and often have fever
 PATHO-PHYSIOLOGY
• Decrease in RBC’s,Hemoglobin or Hemotocrit
level.
Diminished oxygen carrying capacity

Hypoxia and hypoxia-induced effects on

organ function

Signs and symptoms of anemia.

 DIAGNOSTIC EVALUATION
• Haemoglobin/HCT -12-15.5 mg in females,
• 13.5-17.5 mg in males
• MCV – 80 -96 femtolitres per cell
• Serum Iron – 60 to170 mcg/dL
• TIBC – 240 to 450 mcg/dL
• Transferrin – 25 – 35 percent
• Ferritin-12 to 150 ng/mL for females
• 12 to 300 ng/mL for males
• Bilirubin- 0.1 to 1.2 mg/dL
• Serum B12- 190 to 950 pg/mL-
• Folate- 2-20 ng/mL
 MEDICAL MANAGEMENT
• 1)Iron deficiency anemia
• A)Ferrous Sulphate
• Action- iron replacement
• Side Effect-Constipation,black stools,mild nausea.
• Nursing Interventions-
• Take along with food.
• Not with milk,eggs or caffeniated drinks because they
inhibit drug absorption.
• B)Iron Dextran
• Action-iron replacement
• Side-effects- Hypersensitivity reactions,brown skin, discoloration
at the injection site.
• Nursing Interventions
• Test dose.
• Im injection in Z track method
• 3)Vitamin B12(Cyanocobalamine)
• Action-VitaminB12 replacement
• Side-effects- Diarrhoea,hypokalemia,itching, rash at injection
site.
• Nursing Interventions
• To be followed every month.
• 4)Epoetin alfa(Epogen)
• Action- stimulates bonemarrow to produce
RBC’s
• Side-effects-Hypertension,headache,athralgia.
• Nursing Interventions
• 3 times/week until hematocrit is 30-33.
 NUTRITIONAL MANAGEMENT
• The role of nurse is very important in the therapuetic regimen
of anemia.
• The foods to be taken are
• 1)Cobalamine (VitaminB12)-RBC Maturation
• Red meat,liver,eggs,grain,milk and dairy foods and fish.
• 2)Folic Acid- RBC maturation
• Green leafy vegeables,liver,meat,fish,legumes,whole
grains,orange and peanuts.
• 3)Iron- Hemoglobin synthesis
• Liver and muscle meats,dark green leafy vegetables and whole
grain
 NURSING MANAGEMENT
• Nursing Diagnosis
• Fatigue related to inadequate oxygenation of
the blood as evidenced by increased pulse and
blood pressure in response to activity.
• Goal-
• Participates in activities of daily living without
abnormal increase in blood pressure and
pulse.
• Imbalanced nutrition less than body
requirement related to inadequate nutritional
intake and anorexia as evidenced by
weightloss.
• Goal-
• Maintain dietary intake that provides
minimum requirements of nutrients