What is Anemia

Anemia is associated with lower hemoglobin concentration than expected, leading to a reduced ability to transport oxygen in various body parts. In this case, the patient may experience weakness, shortness of breath, headache, fatigue, and rapid heartbeat. Anemia reflects fewer than the average number of red blood cells in the blood circulation.

Classification of Anemia

The classification of Anemia according to the physiologic approach is based on the causes of the electrolytes deficiency, which may include defects in their destruction, production, or loss.

• Bleeding Anemias. This type of Anemia is associated with the loss of red blood cells in the patient’s body due to excessive bleeding. This may cause fatigue, pale skin, weakness, and breathing difficulties. The bleeding anemia types include Hemophilia, Thrombocytopenic purpura, Iron-deficiency, Aplastic Anemia, and Von Willebrand disease.
• Hemolytic Anemias. These disorders are associated with the premature destruction of erythrocytes, causing a shortage of red blood to transport oxygen to different body parts. Hemolytic Anemia might be acquired during a person’s life or inherited (genetic). Some typical types of hemolytic Anemia include Thalassemia, Hereditary spherocytosis, G6PD, Hemolytic Anemia, and Autoimmune hemolytic Anemia.
• Hypoproliferative Anemias. These are a group of disorders associated with the reduced production of erythrocytes. This led to a low amount of oxygen-carrying hemoglobin in the blood and decreased oxygen-carrying capacity of the blood. Pathophysiology

Pathophysiology of Anemia

The pathophysiology of Anemia is related to disruption to the average balance of erythrocytes production and destruction. In this case, Anemia can occur either as a result of reduced production of erythrocytes or increased destruction of erythrocytes.

hypoproliferative Anemia

• Marrow damage. Marrow damage, either by chemicals or medication, and lack of factors causes a reduction in the production of erythrocyte
• Reduced erythrocyte production. Reduced erythrocytes production is reflected in low red blood cells count.

Hemolytic Anemia

• Produced hemoglobin is turned into bilirubin, increasing the blood’s bilirubin concentration.
• Premature destruction. Destruction of red blood cells prematurely causes the liberation of hemoglobin from the red blood cells to the plasma.
• Erythropoietin production. The increased destruction of red blood cells results in tissue hypoxia that activates erythropoietin production.
• Hemolysis is the end product resulting from injury to red blood cells in blood circulation or abnormality within red blood cells or the plasma.
• Increased reticulocytes. Increased production of results in elevated reticulocyte count as bone marrow tries to respond to the loss of red blood cells.

Causes of Anemia

It is easy to tell whether the present Anemia results from inadequate production or destruction of red blood cells based on the following factors.

• The extent to which young red blood cells increase and the manner of maturity as seen in biopsy of the bone marrow.
• Increased reticulocyte count shows the response to reduced red blood cells by the bone marrow in blood circulation.
• Absence or presence of end products of erythrocytes destruction within the circulation.

Clinical Manifestations of Anemia

The symptoms of Anemia become more aggressive with the rapid development of Anemia.

• Dyspnea refers to breathing shortness, mostly during physical activities resulting from reduced oxygen concentration in the blood.
• It is the increased blood pumping by the heart to compensate for the reduced oxygen to ensure enough supply to peripheral tissues of the body.
• Reduced oxygen levels in the tissues cause fatigue or exhaustion in the patient.
• Reduced hemoglobin. The anemia patients have a reduced hemoglobin level of between 9 to 11 g/dl
• Weakness. Anemia patients may experience weakness or insufficient energy, making them less functioning.
• Pale skin. The skin of anemia patients, particularly the nail beds and lips, may appear pale due to reduced red blood cells.
• A reduced supply of oxygen in the brain due to Anemia may cause headaches.
• Chest pain. Severe cases of Anemia can lead to chest pains due to the working of the heart.
• As the brain struggles to get enough oxygen, the anemia patient may experience dizziness or lightheadedness.

Prevention of Anemia

Lifestyle changes are vital in the prevention of Anemia.

• Taking iron supplements. Iron supplements are significant in adding hemoglobin levels to the body.
• Take iron rich diet. Take iron, vitamin B12, and a folate-rich diet. Foods like fish, spinach, red meat, lentils, fortified cereals, and beans can prevent Anemia.
• Stay active. Physical activities help in improving blood circulation and prevent Anemia.
• Avoid iron-blockers. Some foods and drinks can interfere with iron absorption in the body, like coffee, eggs, tea, whole-grain bread, dairy products, and cereals.
• Reduce alcohol intake. Excess intake of alcohol can interfere with nutrient absorption and increase the chances of Anemia.
• Take a Vitamin C diet. Vitamin C is crucial in iron absorption from plant-based sources. Citrus fruits, bell peppers, tomatoes, and strawberries are essential.
• Seek medication incased of heavy periods. Women experiencing heavy bleeding during their menstrual period are at high risk of getting Anemia and should seek medical attention.
• Treat underlying conditions. Certain medical conditions such as inflammation, autoimmune disorders, and celiac disease increase the risk of Anemia and should be treated.

Complications of Anemia

• Paresthesia is a condition that develops when the body’s muscles do not get sufficient oxygen.
• Delirium is an anemic condition that develops when the brain does not get enough oxygen supply and is a life-threatening condition of Anemia.
• Heart failure. Heart failure occurs in anemic patients as there is an irregular heartbeat to compensate for low oxygen levels in the blood. Hence, the heart muscles weaken and wear off, making the heart too weak to function.

Assessment and Diagnostic Findings

Various assessments are performed to determine the causes and the kind of Anemia a patient has.

• Blood assessment. The first evaluation of Anemia involves examining red blood cells, hematocrit, hemoglobin, reticulocyte count, and the red cell distribution with and mean corpuscular volume.
• CBC values. Are essential in assessing if the present Anemia is an isolated problem or is associated with another hematologic condition.
• Iron studies. An iron assessment like serum iron level, ferritin, percent saturation, iron-binding capacity, folate levels, and serum vitamin B12 is significant in diagnosing Anemia.

Medical Management of Anemia

Medical management of Anemia is aimed at controlling the causes of Anemia.

• Blood transfusion. Severe hemolysis and acute blood loss cause reduced perfusion due to reduced blood level or decreased circulating erythrocytes; therefore, blood transfusion is vital.
• Nutritional supplements. The patient should be given adequate information regarding dietary supplements because increased intake does not have an impact on anemia conditions.
• Intravenous fluids. The intravenous fluids are crucial to restore the lost electrolyte or blood to optimum levels.

Nursing Management of Anemia

The nurses must be appropriate and accurate to achieve the objectives and goals of nursing management,

Nursing Assessment of Anemia

Nursing evaluation of Anemia involves:

• Medication history. Bone marrow functions like folate metabolism and hemolysis could be depressed by certain medications.
• Athletic endeavors. It is essential to determine whether the patient engages in any athletic activity because extreme physical exercises can interfere with the survival rate of the erythrocyte and erythropoiesis.
• Nutritional assessment. Evaluation of the patient’s nutritional status is vital in indicating deficiencies in significant nutrients like vitamin B12, folic acid, and iron.
• Physical evaluation and health history. Both health and physical evaluation provides significant insights into the kind of Anemia a patient has, the symptoms produced, and their impact on the patient.
• Alcoholic intake history. It is necessary to gather accurate data on alcohol intake, such as duration and amount.
• Family history. Family history is crucial in assessing Anemia patients because some types of anemias are inherited.

Diagnosis of Anemia

Primary diagnosis of anemia patients based on assessment data includes.

• Fatigue is associated with reduced hemoglobin and decreased oxygen in circulation.
• Disrupted tissue perfusion is linked to inadequate hematocrit and hemoglobin in the blood.
• Compromised nutrition that is lower than the average body requirement is associated with an insufficient intake of vital nutrients.

Planning & Goals

The primary goals for anemia patients include the following.

• Minimized fatigue.
• Reduced complications,
• Adherence to the prescribed therapy.
• Maintain Appropriate tissue perfusion.
• Maintain sufficient nutritional requirements.

Nursing Interventions of Anemia

Nursing interventions primarily depend on the assessment data and the symptoms manifested by the patient.

• Fatigue may be managed by ranking patient activities and striking a balance between rest and acceptable levels of function for the patient. In addition, chronic anemia patients need some physical exercises and activities to minimize deconditioning resulting from idleness.
• Nutritional requirement. Food full of nutrients is crucial for anemia patients. Besides, the patient should be informed of the impact of alcohol on the utilization of vital nutrients; thus, the patient should limit or avoid taking alcoholic beverages. It is also important to have dietary sessions with the patient and the household members and incorporate some cultural values associated with food preparations and preferences.
• The nurses must monitor blood transfusion by closely reading the pulse oximeter and the patient’s vital signs.
• Prescribed therapy. The patient should be assisted in developing techniques for incorporating a therapeutic plan into their daily activities. Furthermore, anemia patients under high-dose corticosteroids should be helped acquire insurance coverage or other means of getting medication.

Evaluation

The expected patient outcome includes:

• Experience reduced fatigue.
• Achieve and maintain sufficient nutrition.
• Reduced complications.
• Maintain enough blood flow.

Discharge and Homecare Guidelines

The primary focus of discharge guidelines is education.

• Iron supplements. Ensure compliance with prescribed iron supplements.
• Follow-up. Encourage the need for laboratory and medical follow-up to assess the progress of the disease and response to therapies.
• Nutritional requirement. Emphasis on the need to take iron-rich nutrients to build hemoglobin storage.

Anemia Documentation Guidelines

The following data should be documented.

• Patient progress towards the set goals.
• Long-term needs.
• Teaching plan
• The religious and cultural boundaries and patient preferences.
• Patient progress towards the set goals.
• Patient response to interventions, teaching, and course of action.
• Subsequent evaluations to include symptoms.