Anaemia

Anaemia

1. Iron Deficiency Anaemia

   • Nursing Priorities
     • Fatigue
       • exhaustion due to poor oxygenation
       • guidance needed balancing activities
       • encourage rest period
       • potential for immobility
     • Breathlessness
       • nurse in upright position
     • Nutrition
       • education on iron-rich foods eg. liver, eggs, legumes
       • Vitamin C aids absorption of iron
     • Safety
       • faintness, lightheadedness
       • advise pt to stand up slowly
     • Skin Intergrity
       • risk for pressure ulcers; use tool
       • concave nails
   • Treatment
     • iron replacement therapy
       • Ferrous sulphate 200mg TID
       • Ferrous gluconate 300mg daily (before food)
       • Ferrous fumarate 200mgs daily
     • side effects; dark stool
     • liquid; drink through straw.. stains teeth

2. Pernicious Anaemia (Vit B12)

   • sources of B12
     • cod, salmon, meat, eggs, cheese
   • megaloblastic anaemia- bone marrow produces abnormally large immature RB which may be too large to exit the bone marrow to carry O2 around the body
   • Nursing Priorities
     • Fatiuge
     • Breathlessness
     • Nutrition
     • Safety
     • Skin integrity (numbness and tingling)
     • Anxiety
   • Treatment
     • IM Hydroxycobalamin 0.25-1mg alternative days x 2wks
     • oral iron to be given BEFORE

3. Folate Anaemia

   • sources of Folic Acid
     • broccoli, spinach, peas, brown bread, brown rice, fruit, veg.
   • Alcohol can interfere with folic acid absorption
   • Anti-epileptic drugs are associated with folate deficiency

4. Aplastic Anaemia

   • bone marrow stem cells that result in a reduction of red cells, white cells and platelets with fatty replacement of bone marrow
     • Confirmed with bone marrow aspiration
   • Nursing Priorities
     • Prevention of life-threatening complications (infection and early detection)
   • Treatment
     • ATG
     • Methylprednisone
     • Cyclosporine
     • BM transplant (last option)

5. Haemolytic Anaemia -Sickle Cell Anaemia

   • Sickle cells anaemia is a severe haemolytic anaemia resulting from inheritance of the HbS gene
     • The cells containing HbS loses its shape and becomes deformed and rigid. These cells become trapped in small blood vessels and pile up resulting in reduced blood flow to tissues and organs
   • Signs and Symptoms
     • Pain
     • Ischaemia
     • weakness and fatigue
     • growth impairment
     • infection
     • damage to vital organs
   • Nursing Priorities
     • Pain Management (PQRST)
     • IV fluids to reduce blood viscosity
     • Administer antibiotics if infection present
     • O2 therapy to reduce hypoxia
     • Blood transfusion on occasion
     • Hydroxyurea
     • fatigue, nutrition, safety, skin integrity, anxiety