Anemia is a common condition defined by a lower-than-normal number of healthy red blood cells or a reduced hemoglobin concentration. Hemoglobin carries oxygen from the lungs to the body’s tissues, so a deficiency impairs the blood’s ability to deliver oxygen. This deficit results in symptoms like fatigue, weakness, dizziness, and shortness of breath. Anemia itself is a medical diagnosis, identifying a specific pathological state, not a nursing diagnosis. The concept of a nursing diagnosis, formalized by the NANDA International, Inc. (NANDA-I) framework, is a separate clinical judgment nurses use to plan care.
Understanding the Distinction Between Medical and Nursing Diagnoses
A medical diagnosis, such as anemia, focuses on identifying the disease, injury, or pathological condition causing the problem. This diagnosis is centered on the underlying etiology and is generally the responsibility of a physician or other advanced practice provider. The purpose of the medical diagnosis is to direct the treatment for the disease itself, which involves identifying and correcting the underlying cause like iron deficiency, vitamin B12 deficiency, or chronic blood loss.
In contrast, a nursing diagnosis is a clinical judgment about an individual’s response to actual or potential health conditions or life processes. This judgment is holistic, focusing on the patient’s experience and the functional problems that arise from the medical condition. The NANDA-I framework provides standardized terminology for these human responses. Therefore, while a physician treats the anemia, a nurse treats the patient’s response to the anemia, such as their difficulty performing daily activities due to weakness.
Specific Nursing Diagnoses Related to Anemia
Because anemia leads to a decreased oxygen supply to the body’s tissues, the resulting physical problems form the basis for several related nursing diagnoses.
Fatigue
One of the most common diagnoses is Fatigue, which reflects the persistent, overwhelming sense of tiredness that is not relieved by rest. This fatigue is directly related to the reduced oxygen-carrying capacity of the blood, which compromises cellular energy production throughout the body.
Activity Intolerance
Closely linked to this is the diagnosis of Activity Intolerance, describing the inability to endure or sustain physical activity due to the physiological stress imposed by low hemoglobin. Patients often exhibit signs of this, such as shortness of breath, an increased heart rate, or generalized weakness upon exertion. The nurse focuses on managing this reduced stamina and its impact on the patient’s quality of life.
Ineffective Tissue Perfusion
Another important diagnosis is Ineffective Tissue Perfusion, related to the compromised circulation of oxygenated blood at the capillary level. When hemoglobin levels are significantly low, the delivery of oxygen to peripheral tissues, including organs like the brain or heart, is insufficient. This lack of adequate oxygenation can manifest as headaches, dizziness, or even chest pain in severe cases.
Imbalanced Nutrition: Less Than Body Requirements
For anemia types caused by dietary deficiencies, such as iron-deficiency or B12-deficiency anemia, the nurse may use the diagnosis Imbalanced Nutrition: Less Than Body Requirements. This diagnosis is appropriate when the patient’s intake of nutrients like iron, folate, or vitamin B12 is insufficient to support red blood cell production. The nurse identifies this issue and plans interventions to correct the nutritional deficit that contributes to the anemic state.
Nursing Interventions for Anemia-Related Patient Problems
Nursing interventions are action-oriented strategies designed to manage the patient problems identified by the nursing diagnoses. For managing fatigue and activity intolerance, a primary goal is to minimize the patient’s oxygen demand and conserve energy. The nurse accomplishes this by planning periods of rest between activities and assisting the patient with mobility and self-care tasks.
Implementing fall precautions is another intervention, as the dizziness and weakness associated with poor oxygenation increase the risk of injury. The nurse monitors the patient’s vital signs and level of exertion carefully before, during, and after activity to prevent overexertion and tissue hypoxia. Supplemental oxygen is also applied as ordered to increase the overall oxygen saturation and ease the workload on the heart and lungs.
Addressing the nutritional component involves patient education and direct management of supplements. The nurse administers prescribed iron, vitamin B12 injections, or folic acid supplements and provides detailed teaching on proper timing and potential side effects, such as gastrointestinal distress from oral iron. Dietary counseling from a dietitian may be arranged to help the patient incorporate iron-rich foods or fortified products into their daily meals.
The nurse also monitors for signs of worsening tissue perfusion, such as pallor, increased heart rate, or changes in mentation, which would indicate a need for a change in the care plan. These autonomous actions focus entirely on alleviating the patient’s symptoms and preventing complications while the medical treatment addresses the underlying cause of the anemia.