ANEMIA

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ANEMIA

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 deficiency (iron, vitamin B12, and 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.

PROGNOSIS
Anemia is a symptom of something else happening. The cause of the anemia needs to be determined in order to correct the anemia and its symptoms.

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

INTERPRETING TEST RESULTS
• Hemoglobin level low.
• Hematocrit level low.
• RBC count low.
• MCV (mean corpuscular volume) shows size of cell—normal (normocytic), microcytic (low), or macrocytic (high).
• MCH (mean corpuscular hemoglobin) shows color of cell—normal (normochromic), hypochromic (low).
• RDW (red cell distribution width) elevated—shows the variation of the cell sizes; there is greater variation in cell size when body is attempting to compensate for anemia.
• Reticulocyte count elevated when RBC cell production is increased to compensate for the anemia.

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.

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