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    Anemia

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    Ansu Maliyakal
    Anemia is defined as a reduction in red blood cell count or hemoglobin level. It can be caused by impaired red blood cell production, increased destruction, blood loss, or dilution. Common types seen in children include iron deficiency, lead poisoning, megaloblastic, and hemoglobinopathies. Symptoms vary based on severity but can include fatigue, pallor, and weakness. Diagnosis involves blood tests to identify type and cause. Treatment focuses on replacing lost blood or iron, reducing destruction, and managing underlying condition. Nursing care aims to prevent complications through nutrition, rest, infection control, and education.

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    Anemia

    Uploaded by

    Ansu Maliyakal
    123 views6 pages
    Anemia is defined as a reduction in red blood cell count or hemoglobin level. It can be caused by impaired red blood cell production, increased destruction, blood loss, or dilution. Common types seen in children include iron deficiency, lead poisoning, megaloblastic, and hemoglobinopathies. Symptoms vary based on severity but can include fatigue, pallor, and weakness. Diagnosis involves blood tests to identify type and cause. Treatment focuses on replacing lost blood or iron, reducing destruction, and managing underlying condition. Nursing care aims to prevent complications through nutrition, rest, infection control, and education.

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    Anemia is defined as a reduction in red blood cell count or hemoglobin level. It can be caused by impaired red blood cell production, increased destruction, blood loss, or dilution. Common types seen in children include iron deficiency, lead poisoning, megaloblastic, and hemoglobinopathies. Symptoms vary based on severity but can include fatigue, pallor, and weakness. Diagnosis involves blood tests to identify type and cause. Treatment focuses on replacing lost blood or iron, reducing destruction, and managing underlying condition. Nursing care aims to prevent complications through nutrition, rest, infection control, and education.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    123 views6 pages

    Anemia

    Uploaded by

    Ansu Maliyakal
    Anemia is defined as a reduction in red blood cell count or hemoglobin level. It can be caused by impaired red blood cell production, increased destruction, blood loss, or dilution. Common types seen in children include iron deficiency, lead poisoning, megaloblastic, and hemoglobinopathies. Symptoms vary based on severity but can include fatigue, pallor, and weakness. Diagnosis involves blood tests to identify type and cause. Treatment focuses on replacing lost blood or iron, reducing destruction, and managing underlying condition. Nursing care aims to prevent complications through nutrition, rest, infection control, and education.

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    Download as docx, pdf, or txt
    of 6

    ANEMIA

    DEFINITION ANEMIA

    Anemia is defined as reduction in volume of  red blood cell count or in concentration of hemoglobin . The normal
    level of hemoglobin is generally different in males and females

    CAUSATIVE FACTORS

    1. Impaired production of RBC and Hb :

    Marrow failure

    a. Diamond-Blackfan anemia (congenital pure red cell aplasia)


    b. Transient erythroblastopenia of childhood
    c. Aplastic crisis caused by parvovirus B19 infection (in patients with an underlying chronic hemolytic
    anemia)
    d. Marrow replacement (eg, malignancies, myelofibrosis, osteopetrosis)

    Impaired erythropoietin production

    e. Anemia of chronic disease in renal failure


    f. Chronic inflammatory diseases
    g. Hypothyroidism
    h. Severe protein malnutrition

    Defect in red cell maturation and ineffective erythropoiesis 

    i. Nutritional anemia secondary to iron, folate, or vitamin B-12 deficiency


    j. Congenital dyserythropoietic anemia
    k. Thalassemias
    l. Erythropoietic protoporphyria
    2. Accelerated destruction of blood cells

    Extracellular causes

    o Mechanical injury (hemolytic-uremic syndrome, cardiac valvular defects)


    o Antibodies (autoimmune hemolytic anemia)
    o Infections, drugs, toxins
    o Thermal injury to RBCs (with severe burns)
     Intracellular causes
    o Red cell membrane defects (eg, hereditary spherocytosis, elliptocytosis)
    o Enzyme defects (eg, G-6-PD deficiency, pyruvate kinase deficiency)
    o Hemoglobinopathies (sickle cell disease, unstable hemoglobinopathies)
    o Paroxysmal nocturnal hemoglobinuria

    3. Blood loss
     Obvious or occult site of blood loss: GI tract, intra-abdominal, pulmonary, intracranial (in neonates)
     Particular risk of massive hemorrhage (internal or external) for patients with bleeding disorder
     Decrease production of platelets
     Increased destruction of platelets
     Decreasing number of clotting factors
    4. Morphologic classification
    5. Physiologic anemia occurs in term infants at ages of 8 to12 weeks hematocritshould not fall below 30 %
    6. May result from chronic illness such as rheumatoid arthritis and other inflammatory diseases

    TYPES OF ANEMIA SEEN IN CHILDREN

    1. Iron deficiency anemia : Iron deficiency anemia is acondition in which total body iron content is decreased
    below normal , affecting hemoglobin synthesis . RBC appear pale and very small

    2. Anemia of chronic lead poisioning


    3. Megaloblastic anemia
    4. Hemoglobinopathies
    5. Transient erythroblastopenia
    6. Anemia from blood loss or bone

    CLINICAL MANIFESTATION

    Conditions may be acute or chronic , the more slowly the onset of anemia , the less likely patient will be
    asymptomatic
    Early symptoms : listenlessness. Fatigability , anorexia related to decresed energy
    Late symptoms : pallor, weakness , tachy cardia. Tachypnea, palpitations, jaundice.

    DIAGNOSTIC EVALUATION

     complete blood count ith indices and reticulocytes vary with types of anemia
     serum iron and total iron binding capacity – ratio of less than 0.2
     serum ferritin – less than 12 g/dl
     lead greater than 20 g/dl
     free erythrocyte protoporyphyrin – greater than 35g/dl
     B12, B6,folate level may be decreased
     Hb electrophoresis- may show Hbs or other abnormality
     Parvo virus B19 titre – may be elevated in transient erythroblatopenia
     Coombs test
    MANAGEMENT

    Iron deficiency anemia

    1. Oral iron at dose of 3 to 6 mg elemental iron /kg per day given between meals . reticulocyte count should
    increase in 7 to 10 days
    2. Dietary : decrease milk intake to 16 oz per day ; include iron fortified cerals and bread products ; increase
    consumption of red meat ; include foods rich in vit C
    3. IRON rarely given IM

    Anemia of chronic lead poisioning

    1. Early detection of high lead levels through screening questionnaires and blood tests
    2. Maintainance of a well balanced diet, high in calcium and vitamin D
    3. Administration of chelating agent ethylnediaminetetraacetic acid or diamercaprol according to
    recommendations of the centre for disease control and prevention
    4. Use lead free paints
    5. Testing of hose and soil
    6. Removal of child iron unsafe environment .

    Hemoglobinopathies

    1. Sicle cell anemia


    2. Thalassemia

    Transient erythroblastpenia of childhood

    1. Spontaneous recovery in 4 to 8 wks


    2. For Hb levels of less than 5 g/dl or cardiac failure , usually a transfusion of packed RBC s.
    Anemia from blood loss or bone marrow suppression
    a. Packed RBC transfusions may be necessary

    COMPLICATIONS

     mental sluggishness , as a result of decreased oxygen and energy for normal activity ; usually normal neutral
    activity ; usually associated with a decreased attention span , decreased intelligence, and lethargy
     growth retardation related to anorexia and decreased cellular metavolism
     delayed puberty related to growth retardation
     cardiac enlargement related to muscular hypertrophy because of increased strain on heart , attempting to
    compensate for increased oxygen demand by tissues eventually results in heart failure
     death related to circulatory collapse and shock.
    NURSING ASSESSMENT

    Obtain history of potential causes


    a. dietary history
    b. family history
    c. persistent infection, fever
    d. exposure to drugs , poisions
    e. pica – craving and consuming nonfood items

    Obtain a baseline assessment

    a. observe skin and mucous membrane


    b. observe height and weight and plot on growth curve
    c. measure vital signs , including blood pressure
    d. assess child s functional level – level of exercise tolerated , mental functioning
    e. assess attainment of development

    Observe for fatigue , listenless , irritability

    Observe for blood loss :bruising , bleeding , hematuria or hematochezia

    NURSING DIAGNOSIS

    1. Fatigue related to decreased ability of blood to transport oxygen to the tissues

    2. Imbalanced nutrition : less than the body requirement of recommended daily dietary allowances

    3. Risk for infection related to debilitated state

    4. anxiety related to hospitalization and painful diagnostic procedures .

    5. delayed growth and development

    NURSING INTERVENTIONS

    MINIMISE FATIGUE

     Plan nursing care


     Observe early signs of fatigue
     Encourage rest
     Administer oxygen in upright position
     Provide finger foods
     Transfuse packed RBC s as directed

    NUTRITION

     Small and frequent feed


     Iron rich foods and vitamins
     Give meals with orange juice ( iron better aborbed in acidic)
     Limit milk to 16 to 24 oz
     Administer liquid iron with dropper to prevent teeth staining
     Dental stains can be removed by brushing with sodium bicarbonate
     Be alert for adverse effects of iron supplements – gastric distress , colicky pain , diarrhea
     Advice family that childs stool may turn black or green
     Avoid tiring activity

    PREVENT INFECTION

    Good hygienic practices


    Avoid exposure to cold and infections
    Report temperature elevation

    REDUCES ANXIETY

     explain procedure
     allow child to handle equipment used for test and procedure

    PROMOTE GROWTH AND DEVELOPMENT

     Age related activities


     Peer socialization
     Age appropriate play
     Periodic growth chart evaluation and developmental testing

    FAMILY EDUCATION AND HEALTH MAINTAINANCE

     Stress to the parents on continuing iron therapy


     Initiate and reinforce good dietary habits
     Discuss general health measures , including adequate rest , diet , sunshine
    BIBLIOGRAPHY

    Lippincott Manual of nursing practice 9th edition Lippincott Williams and wikkins publications:2009

     Pilletri Adele. Child Health Nursing care of child and family. Lippincott publications Philadelphia;
    newyork:1999.
     M .T .Assuma Beeevi. Text book of pediatric nursing sanath printers and publications
     .Wong L Donna,Eaton-Marylin Hockenberry. Essentials of paediatric nursing.6 th edition.Missouri;Mosby
    publishers;2001.
     Marlow DorothyR, redding.Barbara.A.Text book of paediatric nursing.6 th edition. Harwart Brace and
    companyAsia:Delhi;2000
     Guptha Piyush .Essentials of paediatric nursing.1st edition. New delhi:A.P jain and co;2004.
    A PRESENTATION ON
    ANEMIA

    Submitted to Submitted by

    Ms Laviga G Ms Ansu Maliyakal

    Lecturer IInd year Msc Nursing

    NUINS NUINS

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