Anemia

Introduction
A low hemoglobin or red blood cell (RBC) count results in decreased oxygen-
carrying capability of the blood. This may be due to blood loss, damage to the red
blood cells due to altered hemoglobin or destruction (hemolysis), nutritional defi-
ciency (iron, vitamin B12, folic acid), lack of RBC production, or bone marrow
failure. Some patients have a family history of anemia due to genetic transmission,
such as thalassemia or sickle cell.

SIGNS AND SYMPTOMS

• Fatigue due to hypoxia from less oxygen being available to the tissues of
the body
• Weakness due to hypoxia
• Pallor due to less oxygen being available to the surface tissues
• Tachycardia as the body attempts to compensate for less available oxygen by
beating more rapidly to increase blood supply
• Systolic murmur due to increased turbulence of blood flow
• Dyspnea or shortness of breath due to hypoxia as body attempts to get more
oxygen
• Angina as the myocardium is not getting enough oxygen

• Headache due to hypoxia
• Lightheadedness due to hypoxia
• Bone pain due to increased erythropoiesis as body attempts to correct anemia
• Jaundice in hemolytic anemia due to increased levels of bilirubin as red blood
cells break down

TEST RESULTS

• Hemoglobin level low.
• Hematocrit level low.
• RBC count low.


TREATMENT

Correction of the underlying cause is necessary. Treatment may include dietary
modifications and supplementations. See specific anemias below.

NURSING DIAGNOSIS

• Fatigue
• Activity intolerance

NURSING INTERVENTION

• Check vital signs for changes.
• Monitor CBC—hemoglobin, RBC, MCV, MCH, RDW.
• Plan nursing care based on patient tolerance of activity.
• Monitor for angina.