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Anemia
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- 4. INTRODUCTION A condition ofdecrease in the amount of red blood cells(RBCs) or hemoglobin(Hb) in the blood which lowered ability of the blood to carry oxygen. It can affect anyone. But commonly in women, children & elderly. ■ 10% people over the age of 65yr having Anemia. ■ 14% of children under 2yr age having Anemia. ■ 9% women between 12-49yr age having Anemia.
- 6. DEFINITION Anemia is acondition in which the number of red blood cells or their oxygen-carrying capacity is insufficient to meet physiologic needs. W.H.O.
- 7. RISK FACTORS ■ Excesstea/coffee ■ Low iron intake ■ Low vitamin C intake ■ Poverty ■ GIT disease ■ Female ■ Teenager ■ Alcohol abuse
- 8. ETIOLOGY ■ Iron deficiency ■Folate deficiency ■ Vitamin B12 deficiency ■ Chronic disease ■ Excessive bleeding ■ Bone marrow defect ■ Impaired metabolism of spleen ■ Drug induced (chloramphenicol, benzene) ■ Decreased erythropoietin production ■ Genetic factor (sickle cell anemia, thalassemia)
- 11. ANEMIA RBC loss RBC productiondefective RBC destruction
- 12. •Bleeding RBC loss • Irondeficiency anemia • Aplastic anemia • Megaloblastic anemia Defective RBC productive RBC destruction • Sickle cell anemia • Thalassemia • Autoimmune anemia
- 14. 1. IRON DEFICIENCYANEMIA Cause: lower intake of dietary iron which leads to inadequate for hemoglobin synthesis. Symptoms: Smooth & sore tongue, brittle & ridged nails, angular cheilosis. Treatment: Dietary management iron rich foods, ferrous sulfate, ferrous gluconate, ferrous fumarate or injection also.
- 18. 2. APLASTIC ANEMIA ■Cause: Decrease in or damage to marrow stem cell. It can be congenital or acquired. It can also caused by certain drugs, chemicals or radiation damage. Infection & pregnancy can trigger it. ■ Symptoms: Repeated throat infection, dyspnea, chest pain, muscle pain or cramping, tachycardia, weakness, fatigue, pallor, dyspnea, retinal hemorrhage, purpura (bruising), lymphadenopathy and splenomegaly. ■ Treatment: PRBCs & platelets transfusion, Bone marrow transplantation, peripheral blood stem cell transplantation. Immunosuppressive therapy (prevent lymphocyte from destroying stem cells).
- 21. 3. MEGALOBLASTIC ANEMIA ■Cause: Deficiency of vitamin B12 or folic acid, identical bone marrow & peripheral blood changes occur because both vitamins are essential for normal DNA synthesis. ■ Symptoms: Hb <4-5mg/dl, throat infection, dyspnea, chest pain, muscle pain or cramping, tachycardia, weakness, fatigue, pallor, dyspnea, restlessness, sore tongue, mild diarrhea, mild jaundice, vertigo, confusion. ■ Treatment: Dietary food rich in vitamin & folic acid, Tablet Folic acid & Vitamins.
- 24. 4. SICKLE CELLANEMIA ■ Cause: Inheritance of the sickle hemoglobin gene, which causes a defective hemoglobin molecule. ■ Symptoms: Hb 7-10mg/dl, fever, cough, tachycardia, pulmonary hypertension, jaundice, bone marrow expands in childhood, tachycardia, cardiac murmurs, heart failure, body severe pain, sickle crisis. ■ Treatment: Peripheral blood stem cell transplantation, Chemotherapy agent (Hydrae), PRBCs transfusion, Folic acid.
- 27. 5. THALASSEMIA ■ Causes:abnormal decrease hemoglobin content of erythrocytes (hypochromic), smaller than normal erythrocytes (extreme microcytic) , destruction of blood elements (hemolysis). ■ Symptoms: Asymptomatic, late on develop pallor, jaundice, hemoglobinurias, increased reticulocytes count. ■ Treatment: PRBCs transfusion, bone marrow transplantation.
- 29. ASSESSMENT & DIAGNOSTIC FINDINGS ■Hemoglobin ■ Hematocrit ■ Mean Corpuscular Volume (MCV) ■ Red Cell Distribution Width ■ Iron studies (TIBC, folate level) ■ Serum Vitamin B12 ■ Erythropoietin level
- 30. COMPLICATIONS ■ Heart failure ■Paresthesia ■ Delirium ■ Fainting attack ■ Enlarged liver & spleen ■ Swelling whole over body ■ Cardiomegaly
- 31. PREVENTIONS ■ Take ironrich diet. ■ Take folate rich diet. ■ Take Vitamin B12 rich diet. ■ Foods rich in vitamin C include citrus fruits and juices, peppers, broccoli, tomatoes, melons and strawberries. These items help increase iron absorption. ■ Take dried fruit & nuts between meals to provide iron all day. ■ Take Green vegetables; best source of dietary folic acid. ■ Reduce tea and coffee intake as they make it harder for your body to absorb iron. ■ Surgery to prevent abnormal bleeding or splenomegaly.
- 34. MANAGEMENT Management depends onthe cause of the anemia: ■ If anemia is severe, erythropoietin that are lost or destroyed may be replaced. ■ Transfusion of PRBCs. ■ Transfusion of platelets. ■ Managing fatigue. ■ Maintaining adequate nutrition. ■ Monitoring complications.
- 35. NURSING DIAGNOSIS ■ Fatiguerelated to decreased haemoglobin & diminished oxygen carrying capacity to the blood. ■ Altered nutrition, less than body requirement related to inadequate intake of essential nutrients. ■ Altered tissue perfusion related to inadequate haemoglobin & haematocrit. ■ Acute pain related to tissue hypoxia due to agglutination of sickle cell within blood vessels. ■ Knowledge deficit related to sickle crisis prevention.
- 36. NURSING INTEVENTION ■ Managingpain. ■ Managing fatigue. ■ Preventing & managing infection. ■ Maintaining adequate nutrition. ■ Maintain adequate perfusion. ■ Monitoring & managing potential complications. ■ Promoting home & community based care. ■ Providing health education.