Anemia Nursing Care Plan

Subjective Data:

 Fatigue / weakness
 Dizziness
 Shortness of breath
 Chest pain
 Headache

Objective Data:

 Pale or yellowish skin

 Bleeding / hemorrhage
 Syncope
 Hypotension
 Tachycardia
 Abnormal labs (CBC = decreased RBC and HGB)

Nursing Interventions and Rationales:

1. Assess for and control obvious signs of bleeding: External bleeding, Heavy
menstruation (>1 pad per hour), GI bleed
o Excessive loss of blood results in decreased oxygenation and poor perfusion.
2. Perform 12-lead ECG
o Decreased blood volume causes tachycardia and arrhythmias. Monitor for ST
depression and QT prolongation.
3. Replace fluid volume per facility protocol: IV fluids, Blood transfusion for HGB <8
(per protocol and provider)
o For blood loss of >40% volume, immediate transfusion is required
4. Monitor diagnostic testing: Lab values, CT scans for possible liver or spleen
lacerations, Fecal occult blood - non-invasive test to determine if there is a potential
GI bleed
o Abnormal lab values help determine the cause of anemia and a plan of treatment.
Lab values to monitor closely:

HGB (Normal 12-15 g/dL females; 13.5 - 16.5 g/dL males)

B12 (Normal 2 - 20 ng/mL)

Ferritin (Normal 20-300 ng/mL) - the protein that stores iron

Iron (Normal 50-175 ug/dL)

5. Monitor oxygen saturation and administer oxygen as necessary: If SpO2 is <94%,
deliver oxygen via nasal cannula at 2L/min and increase as needed
o Lack of HGB reduces oxygenation and leads to hypoxia which causes damage to
tissues and vital organs.
6. Administer medications
o Pantoprazole (GI bleed) - helps reduce acid and stop bleeding of peptic ulcers

IV fluids and electrolytes as necessitated by lab values

B12 injections or oral supplements - for B12 deficiency

Erythropoietin is a hormone that may be given to treat anemia caused by

chemotherapy or chronic kidney disease that stimulates production of red blood
cells in the bone marrow
7. Provide nutritional education: Increase green leafy vegetables, Incorporate foods
high in vitamin C, Intake of red meat, lamb, poultry and venison as well as fish and
shellfish Intake of seafood and shellfish, Limit or avoid intake of foods high in
calcium
o Leafy greens such as spinach, kale and chard are high in iron and folate

Vitamin C assists in the absorption of iron. Good choices include oranges, red
peppers and strawberries

All meats and most fish and shellfish contain heme iron

Calcium-rich foods such as raw milk, yogurt, cheese and broccoli are high in
calcium, which binds with iron and prevents absorption
Anemia Nursing Care Plan- Imbalanced Nutrition: Less
than body requirements
Nursing actions Rationale
1. Introduce yourself to the patient
1. In order to foster trust which is needed in the
and the folks as the nurse assigned
working relationship
for the shift.
2. Assess the capability of the patient
to ingest nutrients or any other 2. Knowing the factors that may affect digestion or
barriers such as being lactose injestion can help in solving the root problem.
intolerant or has a pancreatic disease
3. Be aware of the medications, 3. The appetite and absorption of food is affected by
eating habits, food preferences of the drug interactions as well as food prefrences by the
patient. patient.
4. Giving an idea regarding the food sources of folic
4. Teach patient and folks about
acid can enable the patient and folks reach the
foods that are sources of fofolc acid.
resources properly.
5. Providing the information about supplements can
5. Encourage intake of folic acid
widen the knowledge of the patient regarding the
supplements.
possibility of the correcting his or her current state.
6. Giving a verbal and written information about a
6. Discuss about a diet plan that is diet plan can ensure continuous nutritional assistance.
economical and easy to prepare to Economical preparations of menus can encourage the
both patients and folks. significant others to comply with the prescribed
dietary regimen.
7. Assist the patient in the activities 7. This conserves the energy level of patients
of daily living. especially in the severity of anemia.