Anemia Nursing Diagnosis and Care Plans

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.

Defining Characteristics:

1. Fatigue and weakness
2. Pallor (pale skin, mucous membranes, and conjunctiva)
3. Shortness of breath on exertion
4. Tachycardia (rapid heart rate)
5. Dizziness or lightheadedness
6. Low hemoglobin and hematocrit levels

Subjective:

• 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.

Objective:

• Pale skin, mucous membranes, and conjunctiva.
• Rapid heart rate (tachycardia).
• Low hemoglobin and hematocrit levels on laboratory tests.

Related Factors:

1. Nutritional deficiencies (e.g., iron, vitamin B12, or folate deficiency).
2. Chronic or acute blood loss (e.g., from gastrointestinal bleeding, menstrual disorders, trauma, or surgery).
3. Bone marrow disorders (e.g., aplastic anemia or myelodysplastic syndrome).
4. Chronic diseases (e.g., chronic kidney disease or inflammatory bowel disease).
5. Inherited disorders (e.g., sickle cell disease or thalassemia).
6. Impaired absorption of nutrients (e.g., celiac disease or gastric bypass surgery).

Risk Population:

• 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.

Associated Problems:

• Decreased tissue oxygenation.
• Impaired physical mobility.
• Risk for falls.
• Altered nutrition.
• Fatigue.
• 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.

Usage Tips:

• 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.

NOC Outcomes:

• Hemoglobin level within the normal range.
• Improved energy level.
• Demonstrates understanding of anemia management.
• Maintains balanced nutrition.

NOC Results:

• Hemoglobin level: 11.7 g/dL (within normal range).
• Reports increased energy and decreased fatigue.
• Demonstrates understanding of dietary modifications

NIC Interventions:

1. Monitor vital signs: Assess the patient’s heart rate, blood pressure, and respiratory rate to identify any abnormalities related to anemia.
2. 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.
3. 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.
4. Administer blood transfusions as ordered: Monitor the patient’s vital signs, assess for transfusion reactions, and provide emotional support during the procedure.
5. 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.
6. 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.

Nursing References

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.

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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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The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes.

This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

Anna Curran. RN-BC, BSN, PHN, CMSRN 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.