Nursing Care Plan and Diagnosis for Activity Intolerance, Anemia, Low A schedule that alternates periods of activity and rest is recommended to help the patient achieve his/her planned activities without becoming fatigued. It is used to screen for disease associated with anemia, to determine the severity of anemia, to monitor the response to treatment for anemia, and to evaluate polycythemia. Saunders comprehensive review for the NCLEX-RN examination. Here are some suggestions: If you have a disease or condition that affects your hemoglobin levels, you should call your healthcare provider anytime your symptoms worsen. The Hb and HCT provide valuable information in an emergency if they are interpreted not in an isolated fashion but in conjunction with other pertinent lab data. hi, Im a nursing student in Lambton college here in Canada, and I really thank you for putting this together, it has been helpful to me and my peers al through clinical placements. If aplastic anemia is the underlying cause, instruct patients to refrain from receiving blood transfusions from potential marrow donors and advise undergoing HLA typing. The following are symptoms of anemia except: A. A value greater than 20 g/dL (200 g/L) can lead to obstruction of the capillaries as a result of hemoconcentration. Nursing Diagnosis: Fatigue related to lack of decreased oxygen-carrying capacity of blood due to decreased hemoglobin levels, secondary to anemia, as evidenced by frequent rest periods, dyspnea or pain during exercise, and verbalized exhaustion. C. Decreased hemoglobin. Mildly increased myositis, pancreatitis, MI, CHF, shock, mononucleosis, C. Interventions - monitor liver enzyme lab values & for jaundice, check patients medication profile for liver toxic medications, Liver enzymeC. your express consent. Generally speaking, a balanced diet with a focus on important nutrients is the best way to maintain healthy red blood cells and hemoglobin. Check for activity intolerance symptoms. Attainment or progress toward desired outcome. September 2020;159(3):10851094, Available at:https://www.gastrojournal.org/action/showPdf?pii=S0016-5085%2820%2934847-2. Hemoglobin is a protein in the blood that carries oxygen and carbon dioxide to and from the tissues and organs back to the lungs. Assess for any signs of bleeding.Bruising or hematomas, blood in the stool or urine, pallor, dizziness, tachycardia, or hypotension are signs of bleeding. Iron deficiency anemia occurs when iron deficiency is . 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.cancer.net/coping-with-cancer/physical-emotional-and-social-effects-cancer/managing-physical-side-effects/anemia), (https://www.ncbi.nlm.nih.gov/books/NBK558904/?msclkid=b8076e40a9e111eca812a958c9ddec1b). C. Fatigue. Early assessment of these symptoms will help the nurse in facilitating immediate treatment. Table of Contents hide 1 Classification of anemias 1.1 Hypoproliferative anemias (due to deficient red cell production). There are numerous forms and representations of anemia, each with its own variability and cause. B. The 10th edition introduces new ICNP diagnoses, care plans that address LGBTQ health issues and electrolytes and acid-base balance, and an Online Care Planner that simplifies the process of customizing care plans. A low hemoglobin level may be a sign of several conditions, including different kinds of anemia and cancer. Nursing Care Plans Related to Low Hemoglobin Fatigue A low hemoglobin level means the patient cannot transport adequate oxygen to the different body organs and tissues, causing the patient to feel weak, tired, and easily fatigued. However, the most typical manifestation is activity intolerance. The nurse should instruct and explain that these risk factors should be avoided. She is a clinical instructor for LVN and BSN students and a Emergency Room RN / Critical Care Transport Nurse. Usually, fatigue hinders the patients capacity to participate and fulfill their societal and familial responsibilities (e.g., working away from home), which makes it difficult to perform certain tasks. They may recommend you try to follow an iron-rich diet. McGraw Hill Education. Iron deficiency anemia (IDA) is the most common cause of anemia worldwide. Fatigue can be brought on by a variety of medical disorders including anemia that results in the patients inability to tolerate physical activities and exercise, but in particular, tissue hypoxia caused by normocytic anemia is a known cause of fatigue. Causes decreased dietary intake, IV fluid deficit, burns, diarrhea, vomiting, diuretics, hyperaldosteronism, renal disease, ascites, 3. Bone Marrow response the BM compensates for the decrease in erythrocyte level, hence the increase in the production and release of reticulocytes in the blood circulation. Assess the degree of activity intolerance.Assess the severity of activity intolerance. Healthcare providers diagnose low hemoglobin by taking samples of your blood and measuring the amount of hemoglobin in it. Anemia is not a specific disease state but an underlying disorder and the most common hematologic condition. Oral iron formulations appear to be similarly effective and tolerated. She received her RN license in 1997. Nursing Diagnosis: Risk for Bleeding related to loss of red blood cells, secondary to anemia. Nursing care plans: Diagnoses, interventions, & outcomes. Alcoholism, exposure to toxic chemicals, dietary problems, and the use of medication that may affect red blood cell production are some of the causative factors of low hemoglobin levels. Your body doesnt make enough red blood cells. Fatigue NCLEX Review and Nursing Care Plans. Monitor hemoglobin, hematocrit, RBC counts, and reticulocyte counts.Decreased RBC indexes are associated with the decreased oxygen-carrying capacity of the blood. Same as EosinophilsDecreased Values - allergic reaction, hyperthyroidism, stressIncreased Values - Myeloproliferative diseases (cancer), leukemia, inflammatory process, healaing process, post surgery, asthma, cold. It demonstrates how to match nursing diagnoses with client assessment findings, established medical or psychiatric diagnoses, and the current treatment plan. Its simple and well summarised. Normal hemoglobin levels are 14 -18 g/dL for adult males and 12 16 g/dL for adult females. RN, BSN, PHNClinical Nurse Instructor, Emergency Room Registered NurseCritical Care Transport NurseClinical Nurse Instructor for LVN and BSN students. Complete blood count This blood test measures a wide range of blood components. The presence of bruises and petechiae usually happens when the patients platelet counts drop. A slightly low hemoglobin count isn't always a sign of illness it can be normal for some people. Clinical alert An Hb value less than 5.0 g/dL (50 g/L) can lead to heart failure and death. Answer: B. For screening purposes, we rely on the HCT and Hb to evaluate polycythemia indirectly. No IM injections, only use and elctric razor Check body orifices for bleeding, guaic stool Increased Values: For the Doctor to treat the disease process. In this article we will discuss nursing care and anemia nursing care plans. Iron is necessary for the production of hemoglobin, which carries oxygen in the blood. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499994/. B. Fresh citrus fruits. Guidelines support transfusing clients with symptoms of anemia, such as fatigue, on the assumption that the increased oxygen delivery will improve the symptoms of anemia (Prochaska et al., 2017). H. pylori can also cause atrophic gastritis, but it can be diagnosed noninvasively. Low hemoglobin is often caused by low iron levels in the blood or iron deficiency anemia and may lead to severe health conditions, including heart problems. The patient should be taught about time management and organization that will help the patient conserve and reduce fatigue. Curtailing the precipitating exercise and using shoes with reinforced soles are helpful in preventing this form of hemoglobinuria (Maakaron & Besa, 2021). D. Hypertension. Copyright 2021 by the American Academy of Family Physicians. The nurse would recommend an increased intake of: A. Assess for signs of activity intolerance.Signs of activity intolerance, fatigue, and reduced tissue oxygenation include dyspnea on exertion, dizziness, headaches, palpitations, and pallor. Hemoglobin is a specialized protein found in the blood, concurrently carried by the red blood cells or erythrocytes. Sometimes, conditions and diseases affect your bone marrows ability to produce or support enough red blood cells. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Paul Martin R.N. Nursing Diagnosis: Risk for Bleeding related to low hemoglobin and bone marrow malfunction secondary to aplastic anemia. It is important to instruct the patient to eat foods that contain essential nutrients which are needed to promote RBC formation. Intervention: Steadily increase the patients activity through progressively advancing the following (note: increase workout repetition and frequency than intensity): a) In-bed activities to improve range of motion (ROM). Educate the patient on bleeding control measures such as: Making the switch from tampons to pads. 2. Option A: Fatigue is a symptom of anemia as a result of decreased oxygenation. Anemia is usually discovered and quantified by measurement of the RBC count, hemoglobin concentration, and hematocrit (Maakaron & Besa, 2021). Copyright 2023 American Academy of Family Physicians. It is the authoritative guide to nursing diagnoses, reviewed and approved by the NANDA International Diagnosis Development Committee (DDC). Check the cause and the level of the patients fatigue. A full blood count is performed to establish the patients blood profile and identify deviations from the norm from which appropriate corrections can be made. Hello, Im a BSN student at the Catholic University of Eastern Africa. Nursing Diagnosis: Activity Intolerance related to a mismatch in the supply and demand of oxygen, secondary to anemia, as evidenced by a sedentary lifestyle, a general lack of strength, lethargy, a decrease of physical and physiologic adaptation. In conditions wherein the hemoglobin levels are low, this would result in lower oxygen concentration in the blood and tissues thereby inhibiting the body from accomplishing normal physiology and processes. abnormal cravings, or the presence of pica to non-food items such as dirt, etc. Desired Outcome: The patient will have normal platelet levels with the absence of bleeding, bruising and petechiae. Bleeding typically occurs if platelet counts fall below 20,000 per mm3. This will develop the patients endurance and will help prevent complications due to prolonged bed rest. Inability to maintain the usual level of physical activity. 5. 5 Nursing care plans for anemia | Anemia nursing interventions January 29, 2022 by R K SIR BSN RN Anemia is a condition in which the hemoglobin concentration is lower than normal. Without anemia, the ferritin threshold for iron deficiency is uncertain. Energy conservation techniques may help the patient learn new skills and priorities for the desired activities of daily living. Clients with severe anemia should curtail their activity until the anemia is partially corrected. It can also be due to trauma or injury inflicted to the RBC membrane that causes liberation of its contents. Author disclosure: No relevant financial affiliations. PDF EDUCATE YOUR DIALYSIS PATIENTS ABOUT ANEMIA - National Kidney Foundation Policy. Bleeding gums. Otherwise, scroll down to view this completed care plan. Ask the patient about his or her manifestation of activity intolerance and ask him or her to rate perceived exertion on a scale of 0-10. Assist the patient in prioritizing activities and establishing balance between activity and rest that would be acceptable to the patient. 5.6 Management of Hypoxia - Clinical Procedures for Safer Patient Care This handbook is designed for practicing nurses and nursing students, providing guidance in selecting appropriate nursing diagnoses and writing care plans. (https://www.cancer.gov/publications/fact-sheets?msclkid=7446ef3fa9e111ec86449ced5f55f9e4), (https://www.merckmanuals.com/home/blood-disorders/spleen-disorders/enlarged-spleen?msclkid=46277053a9e211ecaa9aaec74a1acaf8), Pathology & Laboratory Medicine Institute (R. Tomsich). Published: March 16, 2022. Epub 2017 Apr 12. Explain that this increases their risk of injury and will further worsen activity intolerance and fatigue. Enforce strict compliance in taking iron supplements as prescribed by the physician. Treating H. pylori infection improves the benefit of iron supplementation in anemia. Use of electric shaver rather than a razor. Assess and implement additional treatments for hypoxia if appropriate. Anemia is a medical condition wherein a person lacks sufficient RBC count, hemoglobin, and hematocrit values resulting in a reduced oxygen-carrying and transport capacity of the blood to the bodys vital tissues. Treatment Low K diet, Kayexalate po or enemas, Lasix , Check I&O, IV infusion of glucose & insulin solution to move K back into the cells, create, study and share online flash cards, Click here to study/print these flashcards, Normal: 80 - 98/um3 (cubic micro meters) Size of RBC. A risk diagnosis is not evidenced by signs and symptoms, as the problem has not occurred yet, and nursing interventions are directed at the prevention of signs and symptoms. Reviewed: May 4, 2022.
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