nursing diagnosis for iron deficiency anemia

Iron Deficiency Anemia Nursing Diagnosis & Care Plan

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Iron deficiency anemia is a common hematologic disorder characterized by decreased hemoglobin levels due to insufficient iron stores. This nursing diagnosis focuses on identifying and treating symptoms, preventing complications, and improving patient outcomes through evidence-based interventions.

Causes (Related to)

Iron deficiency anemia can develop due to various factors affecting iron intake, absorption, or loss:

  • Decreased Iron Intake
    • Poor dietary habits
    • Vegetarian/vegan diet
    • Malnutrition
    • Limited access to iron-rich foods
  • Impaired Iron Absorption
  • Increased Iron Loss
  • Increased Iron Demands
    • Pregnancy
    • Rapid growth (infants/adolescents)
    • Recovery from major surgery
    • Chronic kidney disease

Signs and Symptoms (As evidenced by)

Subjective: (Patient reports)

  • Fatigue and weakness
  • Shortness of breath with activity
  • Dizziness
  • Headaches
  • Difficulty concentrating
  • Cold intolerance
  • Restless legs syndrome
  • Pica (craving non-food items)

Objective: (Nurse assesses)

  • Pale skin and mucous membranes
  • Brittle nails
  • Tachycardia
  • Decreased hemoglobin and hematocrit
  • Low serum ferritin levels
  • Koilonychia (spoon-shaped nails)
  • Angular cheilitis
  • Glossitis

Expected Outcomes

Successful management of iron deficiency anemia includes:

  • Hemoglobin and hematocrit levels will improve
  • The patient will report increased energy levels
  • The patient will demonstrate improved exercise tolerance
  • The patient will maintain adequate iron intake through diet and supplements
  • The patient will verbalize understanding of iron-rich food sources
  • The patient will demonstrate proper medication administration
  • The patient will show no signs of complications

Nursing Assessment

Monitor Blood Values

  • Check hemoglobin and hematocrit levels
  • Monitor serum ferritin
  • Assess iron binding capacity
  • Track reticulocyte count
  • Document MCV and MCH values

Evaluate Physical Status

  • Assess skin color and mucous membranes
  • Monitor vital signs
  • Check for signs of bleeding
  • Evaluate exercise tolerance
  • Assess nutritional status

Review Medications and Diet

  • Document current medications
  • Assess dietary habits
  • Review supplement use
  • Check for medication interactions
  • Evaluate absorption factors

Monitor for Complications

  • Assess cardiac function
  • Check for signs of tissue hypoxia
  • Monitor for infection risk
  • Evaluate wound healing
  • Track cognitive function

Nursing Care Plans

Nursing Care Plan 1: Activity Intolerance

Nursing Diagnosis Statement:
Activity Intolerance related to decreased oxygen-carrying capacity secondary to iron deficiency anemia as evidenced by fatigue, dyspnea on exertion, and tachycardia with minimal activity.

Related Factors:

  • Decreased hemoglobin levels
  • Reduced oxygen delivery to tissues
  • Fatigue
  • Weakness
  • Cardiac workload compensation

Nursing Interventions and Rationales:

  1. Assess activity tolerance level
    Rationale: Establishes baseline and guides activity progression
  2. Plan activities with rest periods
    Rationale: Prevents excessive fatigue and promotes energy conservation
  3. Monitor vital signs before, during, and after activity
    Rationale: Identifies early signs of intolerance
  4. Teach energy conservation techniques
    Rationale: Helps patient manage daily activities effectively

Desired Outcomes:

  • The patient will demonstrate improved activity tolerance.
  • The patient will maintain stable vital signs during activities
  • The patient will report decreased fatigue levels
  • The patient will perform ADLs without excessive fatigue

Nursing Care Plan 2: Imbalanced Nutrition

Nursing Diagnosis Statement:
Imbalanced Nutrition: Less than Body Requirements related to insufficient iron intake as evidenced by low hemoglobin levels and inadequate dietary iron consumption.

Related Factors:

  • Poor dietary habits
  • Limited knowledge of iron-rich foods
  • Decreased appetite
  • Cultural or religious dietary restrictions
  • Economic constraints

Nursing Interventions and Rationales:

  1. Assess current dietary habits
    Rationale: Identifies nutritional deficiencies and barriers
  2. Provide education about iron-rich foods
    Rationale: Improves dietary choices and iron intake
  3. Teach proper food combinations for maximum iron absorption
    Rationale: Enhances iron absorption and utilization

Desired Outcomes:

  • The patient will demonstrate an understanding of iron-rich food sources
  • The patient will incorporate iron-rich foods into a daily diet
  • The patient will show improvement in hemoglobin levels
  • The patient will maintain adequate nutritional intake

Nursing Care Plan 3: Ineffective Health Management

Nursing Diagnosis Statement:
Ineffective Health Management related to insufficient knowledge about iron deficiency anemia as evidenced by verbalized confusion about treatment regimen and poor adherence to iron supplementation.

Related Factors:

  • Knowledge deficit
  • Complex treatment regimen
  • Side effects of iron supplements
  • Cultural beliefs
  • Language barriers

Nursing Interventions and Rationales:

  1. Provide education about the condition and treatment
    Rationale: Increases understanding and promotes compliance
  2. Teach proper supplement administration
    Rationale: Maximizes absorption and minimizes side effects
  3. Address barriers to adherence
    Rationale: Improves treatment compliance

Desired Outcomes:

  • The patient will demonstrate an understanding of the treatment plan
  • The patient will correctly take iron supplements as prescribed
  • The patient will identify strategies to manage side effects
  • The patient will maintain follow-up appointments

Nursing Care Plan 4: Fatigue

Nursing Diagnosis Statement:
Fatigue related to decreased oxygen-carrying capacity and reduced energy production as evidenced by verbalized exhaustion and decreased performance in daily activities.

Related Factors:

  • Anemia
  • Poor sleep quality
  • Increased energy demands
  • Psychological stress
  • Nutritional deficiencies

Nursing Interventions and Rationales:

  1. Assess fatigue levels and patterns
    Rationale: Establishes baseline and identifies contributing factors
  2. Implement energy conservation strategies
    Rationale: Helps manage limited energy resources
  3. Promote adequate rest and sleep
    Rationale: Supports energy restoration

Desired Outcomes:

  • The patient will report improved energy levels
  • The patient will demonstrate effective use of energy conservation techniques
  • The patient will maintain a balanced rest/activity schedule
  • The patient will identify factors that increase fatigue

Nursing Care Plan 5: Risk for Falls

Nursing Diagnosis Statement:
Risk for Falls related to dizziness and weakness secondary to iron deficiency anemia as evidenced by unsteady gait and reported episodes of lightheadedness.

Related Factors:

  • Dizziness
  • Weakness
  • Fatigue
  • Visual disturbances
  • Environmental hazards

Nursing Interventions and Rationales:

  1. Assess fall risk using a standardized tool
    Rationale: Identifies the level of risk and guides interventions
  2. Implement fall prevention measures
    Rationale: Reduces risk of injury
  3. Teach safety strategies
    Rationale: Promotes patient independence while maintaining safety

Desired Outcomes:

  • The patient will remain free from falls
  • The patient will demonstrate safe mobility techniques
  • The patient will identify and minimize fall risk factors
  • The patient will maintain a safe environment

References

  1. Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2023). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. 
  2. DeLoughery TG, Jackson CS, Ko CW, Rockey DC. AGA Clinical Practice Update on Management of Iron Deficiency Anemia: Expert Review. Clin Gastroenterol Hepatol. 2024 Aug;22(8):1575-1583. doi: 10.1016/j.cgh.2024.03.046. Epub 2024 Jun 12. PMID: 38864796.
  3. Harding, M. M., Kwong, J., & Hagler, D. (2022). Lewis’s Medical-Surgical Nursing: Assessment and Management of Clinical Problems, Single Volume. Elsevier.
  4. Herdman, T. H., Kamitsuru, S., & Lopes, C. (2024). NANDA International Nursing Diagnoses – Definitions and Classification, 2024-2026.
  5. Ignatavicius, D. D., Rebar, C., & Heimgartner, N. M. (2023). Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care. Elsevier.
  6. Jimenez K, Kulnigg-Dabsch S, Gasche C. Management of Iron Deficiency Anemia. Gastroenterol Hepatol (N Y). 2015 Apr;11(4):241-50. PMID: 27099596; PMCID: PMC4836595.
  7. O’Sullivan TA, Jayasuriya PH, Tsalis N, Calogero N, Manocha R. Nurses’ understanding and management of iron deficiency in Australia: a cross-sectional, exploratory study. BMJ Open. 2023 Feb 20;13(2):e065706. doi: 10.1136/bmjopen-2022-065706. PMID: 36806134; PMCID: PMC9944295.
  8. Silvestri, L. A. (2023). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. 
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Anna Curran. RN, BSN, PHN

Anna Curran. RN, BSN, PHN I am a Critical Care ER nurse. I have been in this field for over 30 years. I also began teaching BSN and LVN students and found that by writing additional study guides helped their knowledge base, especially when it was time to take the NCLEX examinations.
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