Anemia-Definition-CLASSIFICATION OF ANEMIA-CAUSATIVE FACTORS-DIAGNOSTIC FINDINGS-Iron deficiency anemia.

 

ANEMIA:

 

DEFINITION: Anemia is defined as a reduction below normal in the volume of red blood cells (RBCs) or in the concentration of hemoglobin.

Or

Anemia it is a condition in which the Hb % concentration is lower than normal, reflects the presence of fewer than normal RBCs within the circulation.

 

CLASSIFICATION OF ANEMIA:

1. Hemolytic anemia.

Eg: 1. Sickle cell anemia.

2. Thalassemia.

 

2. Hypo proliferative anemia:

1. iron deficiency anemia.

2. aplastic anemia.

3. Megaloblastic anemia.

 

 

1.  an impaired production of RBCs and hemoglobin.

2. An accelerated destruction of RBCs.

3. Blood loss.

4. It can also be classified morphologically.

 

CAUSATIVE FACTORS:

 

1.  Impaired productions of RBCs and hemoglobin.

Nutritional deficiency

Deficiency of iron, vitamin B6, Vitamin C, Folic Acid and amino acids, copper etc.

Bone marrow failure due to drugs intake.

2. Accelerated destruction of RBCs.

Intake of toxic drugs, venoms or lead substances.

Thermal injury /burns

Splenic enlargement.

Thalassemia.

Sickle cell anemia.

 

In this method intracorporal cells and extracorporeal cells can be affected in our body.

3. Morphologically

TYPES OF ANEMIA:

1. Hemolytic anemia.

Eg: 1. Sickle cell anemia.

2. Thalassemia.

 

2. Hypo proliferative anemia:

1. iron deficiency anemia.

2. aplastic anemia.

3. Megaloblastic anemia.

Clinical Manifestation:

Cardiopulmonary diseases

Vascular collapses

Tachycardia

Fatigue

Hypoglycemia

Liver diseases

Enzyme deficiencies

Stomatocytosis

Dyspnea

Decreased activity of CNS

Weakness.

Improper development of bone cells (osteocytes)

ASSESSMENT AND DIAGNOSTIC FINDINGS:

1.  Hemoglobin test

2. Iron studies

3. Bone marrow aspiration for estimation of osteocytes.

4. Assessment of vitamins (Vitamin  D1 and D3, B. Complex)

 

COMPLICATIONS:

Severe anemia includes heart failure, dark stools, diarrhea, anorexia, glossitis, angina symptoms, hypoglycemia, coma.

 

MEDICAL  MANAGEMENT :

Transfusion of RBCs

Administration of Folic acid  and Ferrous sulphate

Iron contained diet.

 

NURSING MANAGEMENT :

Medical management is depending upon their causes

1. A complete nursing assessment (Nursing history and PE)

2. Preparation for laboratory studies.

3. Reduction of the need for oxygen.

4. Administration of O2 therapy.

5. Administration of transfusion therapy.

6. observation for manifestation of infectious and complication.

7. education of the parents and child.

 

18-49 years                                13.5-17.5 Males

Females 12.0-16.0

Infants

1-3 days                                         14.5-22.5 mg/dl

2 months                                        9.0-14.0

6-12 years                                     11.5-15.5

12-18 years                           M     13.0-16.0    F        12.0-16.0

 

Hypo proliferative anemia

 

Iron deficiency anemia:

It is caused by a lack of sufficient iron for the synthesis of Hb% is most prevalent nutritional and hematologic disorders.

It is common in infants and children and adults.

 

INCIDENCE:

It is common in all races

Poor socio-economic groups.

Most commonly found in 2-5 years of age.

 

ETIOLOGICAL FACTORS:

Insufficient supply at birth.  Blood is going to loss during the birth.

Insufficient intake during periods of rapid growth.

Full term newborn contains about 0-5 gm of iron.

Iron is circulation RBCs and stored in liver, spleen and in bone marrow.

First 4-5 months a full term infant needs 0.8-1.5 mg iron needs in each day.

 

Impaired absorption:

Due to diarrhea and dysentery.

Blood loss:

Due to occult bleeding.

 

Clinical management :

Sore tongue, brittle and ridged nails, ulceration of mouth:

Gastrointestinal bleeding and pica. Gastrointestinal tumors, bowel disorders and menorrhagia (excessive menstrual bleeding).

Gastrointestinal bleeding will be more in case of alcoholic patients.

Cardiac dilation, tachycardia.

 

PATHOPHYSIOLOGY:

Iron is necessary for the productions of hemoglobin.

Depletion of iron stores and reduction of serum transferring saturation (serum globulin and binds and transports)

Decreased production of Hb %.

RBCs become smaller and less and pale.

Reduced Hb level and ____

Reduced O2 carrying capacity of the blood.

 

DIAGNOSTIC EVALUATION:

1. Bone marrow aspiration.

2. Hb % test.

3. History collect.

4. Blood test i.e. TC, BC, and RBCs count, serum test.

5. Assessment dietary intake.

6. Stool examination.

 

Medical management :

Iron deficiency should be investigated in case of pregnancy.

Stool specimens should be tested for occult blood.

About 50 years older age conduct a colonoscopy, x-ray, endoscopy for in case of GI bleeding and ulceration  and gastritis.

Administration of FA and FS.

Iron through the oral route.

Iron the IV / IM after test dose.

Epinephrine to avoid allergic reactions.

 

Nursing Management :

Preventive education is important, e.g. iron deficiency anemia is common in menstruating and pregnant woman.

Provide iron rich content food.

e.g.: chicken liver, beef liver, meats, beans, leafy greens, vegetables.

Advise of Vitamin C.

Provide of iron therapy.

e.g: inferon 50 mg.

parent education is necessary in case of infants and children.

Provide oral iron supplements.

e.g.:  sulfate, gluconate, fumarate.

Iron , FA and FS and Vitamin B12.

 

Selected food sources of iron for infants.

Source quantity           iron(mg)

Human milk

Cow’s milk