Last updated on June 15th, 2023 at 11:30 pm
Anemia is a condition characterized by a decrease in the number of red blood cells (RBCs) or a decrease in the amount of hemoglobin in the blood, resulting in reduced oxygen-carrying capacity. The NANDA nursing diagnosis for anemia is formulated as follows:
Imbalanced Nutrition: Less Than Body Requirements related to inadequate intake of iron and vitamins, blood loss, or impaired absorption.
- Fatigue and weakness
- Pallor (pale skin, mucous membranes, and conjunctiva)
- Shortness of breath on exertion
- Tachycardia (rapid heart rate)
- Dizziness or lightheadedness
- Low hemoglobin and hematocrit levels
- Patient may report feeling tired, weak, or exhausted even with minimal activity.
- Patient may complain of shortness of breath during physical exertion.
- Patient may report dizziness or lightheadedness.
- Pale skin, mucous membranes, and conjunctiva.
- Rapid heart rate (tachycardia).
- Low hemoglobin and hematocrit levels on laboratory tests.
- Nutritional deficiencies (e.g., iron, vitamin B12, or folate deficiency).
- Chronic or acute blood loss (e.g., from gastrointestinal bleeding, menstrual disorders, trauma, or surgery).
- Bone marrow disorders (e.g., aplastic anemia or myelodysplastic syndrome).
- Chronic diseases (e.g., chronic kidney disease or inflammatory bowel disease).
- Inherited disorders (e.g., sickle cell disease or thalassemia).
- Impaired absorption of nutrients (e.g., celiac disease or gastric bypass surgery).
- Individuals with poor dietary intake, particularly those with limited access to iron-rich foods.
- Women of childbearing age due to menstrual blood loss.
- Individuals with chronic diseases or conditions that affect nutrient absorption or blood production.
- Older adults, as they are more prone to nutritional deficiencies and chronic diseases.
- Decreased tissue oxygenation.
- Impaired physical mobility.
- Risk for falls.
- Altered nutrition.
- Ineffective coping.
Suggestions for Use:
- Assess the patient’s dietary intake, focusing on iron-rich foods and sources of vitamins necessary for RBC production.
- Monitor the patient’s vital signs, including heart rate and blood pressure.
- Perform a physical examination to assess for pallor, fatigue, and shortness of breath.
- Order laboratory tests such as hemoglobin, hematocrit, and iron studies to confirm the diagnosis of anemia.
- Collaborate with other healthcare professionals to address the underlying cause of anemia.
Suggested Alternative NANDA Diagnoses:
Nursing Care Plan for Anemia
- Fatigue related to decreased oxygen-carrying capacity of RBCs.
- Impaired Gas Exchange related to decreased oxygen-carrying capacity of RBCs.
- Risk for Falls related to weakness and dizziness.
- Deficient Knowledge related to anemia management.
- Monitor the patient’s response to treatment, including improvement in hemoglobin and hematocrit levels.
- Educate the patient about the importance of adherence to prescribed treatments and dietary modifications.
- Encourage the patient to maintain a well-balanced diet rich in iron, vitamins, and other nutrients.
- Hemoglobin level within the normal range.
- Improved energy level.
- Demonstrates understanding of anemia management.
- Maintains balanced nutrition.
- Hemoglobin level: 11.7 g/dL (within normal range).
- Reports increased energy and decreased fatigue.
- Demonstrates understanding of dietary modifications
Nursing Interventions for anemia.
- Monitor vital signs: Assess the patient’s heart rate, blood pressure, and respiratory rate to identify any abnormalities related to anemia.
- Administer prescribed iron supplements: Ensure proper dosage and timing of iron supplements, and educate the patient on potential side effects such as constipation or gastrointestinal upset.
- Encourage a well-balanced diet: Collaborate with a registered dietitian to develop a nutrition plan that includes foods rich in iron, vitamin B12, and folate, such as leafy green vegetables, lean meats, fortified cereals, and legumes.
- Administer blood transfusions as ordered: Monitor the patient’s vital signs, assess for transfusion reactions, and provide emotional support during the procedure.
- Educate the patient on self-care: Teach the patient about the importance of maintaining a healthy lifestyle, including regular exercise, stress management, and adequate rest to minimize fatigue and optimize overall well-being.
- Collaborate with other healthcare professionals: Consult with a hematologist, gastroenterologist, or other specialists as needed to address the underlying cause of anemia and ensure comprehensive care.
Nursing Test Questions for Anemia
Question 1: A client with anemia reports feeling fatigued and weak even with minimal activity. Which nursing intervention is most appropriate for this client?
a) Encouraging a high-protein diet
b) Assisting with ambulation and mobility
c) Administering pain medication
d) Monitoring blood glucose levels
Answer b: Rationale: The client’s fatigue and weakness are related to decreased oxygen-carrying capacity in anemia. Assisting with ambulation and mobility will help conserve energy and prevent falls.
Question 2: A nursing student is reviewing the laboratory results of a client with suspected anemia. Which finding would support this diagnosis?
a) Elevated hemoglobin levels
b) Low hematocrit levels
c) Increased white blood cell count
d) Elevated platelet count
Answer b: Rationale: Low hematocrit levels indicate a decreased proportion of red blood cells, which is consistent with anemia.
Question 3: A client with anemia is prescribed iron supplements. Which instruction should the nurse provide to the client regarding iron supplementation?
a) Take the supplement with a glass of milk.
b) Take the supplement on an empty stomach.
c) Take the supplement with a high-fiber meal.
d) Take the supplement with a cup of coffee.
Answer b: Rationale: Iron supplements should be taken on an empty stomach for better absorption. Taking them with milk, high-fiber meals, or coffee can interfere with iron absorption.
Question 4: A client with anemia is experiencing shortness of breath and rapid heart rate. Which nursing intervention is a priority for this client?
a) Encouraging deep breathing exercises
b) Administering oxygen therapy
c) Assisting with ambulation
d) Providing emotional support
Answer b: Rationale: Shortness of breath and rapid heart rate are signs of decreased tissue oxygenation. Administering oxygen therapy will help improve oxygen levels and relieve symptoms.
Question 5: A client with anemia is at risk for falls. Which nursing intervention would help prevent falls in this client?
a) Encouraging independence in activities of daily living
b) Providing a well-lit environment
c) Administering anticoagulant medication
d) Encouraging fluid intake
Answer b: Rationale: Providing a well-lit environment reduces the risk of falls by improving visibility and promoting safety.
Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.
Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier.
Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.
Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.
Best Nursing Books and Resources
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This is an excellent reference for nurses and nursing students. While it is a great resource for writing nursing care plans and nursing diagnoses, it also helps guide the nurse to match the nursing diagnosis to the patient assessment and diagnosis.
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