Presentation Ms 1 (Group 2) ANEMIA
MEDICAL & SURGICAL 1
BLOOD
(ANEMIA)
GROUP 2
DEFINITION OF ANEMIA
decrease in normal number of red blood cells(RBCs) or
less than the normal quantity of hemoglobin in the blood
Condition which occurs when have abnormally low
amount of red blood cell
ETIOLOGY
1. Blood loss
- acute or chronic.
o Acute
- interstitial fluid diffuses into the intravascular space and dilutes the
remaining RBC mass.
- levels of polymorphonuclear granulocytes, platelets, and, in
severe hemorrhage, immature WBCs and normoblasts may rise.
o Chronic blood loss
- loss is more rapid than can be replaced or, more commonly, if
accelerated erythropoiesis depletes body iron stores
2. Destruction of RBC
Happen due to the infection or certain medication
Impaired erythropoiesis,
Lead to type of anemia
not sufficient to decrease the numbers of RBCs,
causes abnormal RBC size and shape.
Inherited condition :
Thalassemia
Sickle cell disease
3. Inadequate production of RBC
Deficiency of essential factor (iron , vit B12, erythropoietin)
Body produce too few blood cell
Blood cell not work properly
Toxic hormone
Inflammatory disease , liver or kidney failure medication
example :
Sickle cell anemia
Iron deficiency anemia
Vit B12 deficiency
Bone marrow problem
OTHER CAUSE OF ANEMIA
Poor diet:
low diet in iron and vitamins, especially folic acid
raw materials needed to produce sufficient numbers of red blood cells.
Family history:
inherited genes
Alcoholism:
Chronic drinking
Y? because alcohol interferes with the absorption of folic acid.
Vegetarians
not get enough iron or vitamin B12 in their food.
Chronic conditions like kidney or liver failure, and cancer increases
Chronic blood loss from some parts of the body due to ulcers, haemorrhoids,
etc, may lead to iron deficiency anaemia.
Intestinal conditions like Crohn’s disease:
Intestinal polyps and even intestinal surgery can result in nutritional deficiencies
Y? because of poorer absorption.
Other conditions:
blood disorders,
autoimmune disorders,
exposure to toxins and chemical,
and the use and abuse of certain medicines can affect red blood cell production
-cancer drug
PATHOPHYSIOLOGY
A decrease of number of RBC can be traced
to 3 difference condition :
I. Impaired of production RBC
II. Increased destruction of RBC , as in Hemolytic
and Sickle cell anemia
III. Massive or chronic blood loss
Some anemia are related to genetic
problem
TYPE OF ANEMIA
1. IRON DEFICIENCY ANEMIA
- due to blood loss, poor diet, or an inability to absorb enough
iron from foods.
2. PERNICIOUS ANEMIA (Vitamin B12 deficiency)
-anemia cause by failure to absorb dietary vitamin B12
3. FOLATE ACID DEFICIENCY ANEMIA
- cause by inadequate intake of folic acid
4. MEGALOBLASTIC ANEMIA
- an anemia (of macrocytic classification) that result from inhibition of DNA synthesis
in red blood cell production
- often due to deficiency of vitamin B12 or folic acid
5. HEMOLYTIC ANEMIA
- not enough red blood cell in the blood , due to premature of red
blood cells
6. SICKLE CELL ANEMIA
- diseases passed down through families in red blood cell form an
abnormal prescent shape
- shaped like ‘ C ‘ or like a disc
7. G6PD ANEMIA
- doesn’t have enough of enzyme glucose-6-phosphate
dehydrogenase
- help RBC function normaly
8.THALASSEMIA
- an inherited form of hemolytic anemia
- RBC (HEMOGLOBIN) production abnormilities
SIGN AND SYMPTOM
Depend on severity diseases
Fatigue
Weakness
dizziness
Palpations (feeling the heart racing or beating
irregular)
Looking pale
Low blood pressure
Cold skin
Jaundice (due to BRC breakdown)
Enlargement of the spleen (certain cause of anemia)
INVESTIGATION
Investigation based on type of anemia
Physical examination
Family history
Laboratory review
Complete blood count
- to determine number of red blood cell and white cell
Blood smear examination
- indicate the cause of anemia
Iron test
- include total serum iron and ferreting test
- determine whether anemia is due to iron deficiency
Hemoglobin electrophoresis
-identify various abnormal heamoglobin in the blood
- to diagnosis sickle cell and thalassemia
Bone marrow aspiration and biopsy
- a determine whether cell production is happening normally
Reticulocyte anemia
- a measure the young RBC’s
-help to determine if RBC production is at normal level
Serum folate
- measure if folic acid deficiency is suspected.
COMPLICATION
Complications list for Anemia:
Angina heart damage
Heart failure
Heart attack
Skin discoloration
Cardiac failure
Chest pain
Headache
TREATMENT
Treatment for anemia is based on type ,cause and severity of the
anemia
Treatment include investigation, diagnosis and management of the
underlying causes
Treatment:
- high iron diet
- healthy diet
- vitamin B12 supplement
- blood transfusion
Eat well balanced meal that high biological value of protein
Meat , poultry , fish , egg , milk , dairy product
½ serving fresh fruit and 2/3 serving
vegetable
- to provide required folic acid
Vit C
- found abundance in fresh fruit promote
for better absorption of folic acid and
iron from food
- Long-term or serious illnesses
kidney disease,
cancer,
diabetes,
rheumatoid arthritis,
inflammatory bowel disease (including Crohn’s
disease),
liver disease
Kidney failure
thyroid disease
HOW TO PREVENT
1) Increased intake of deficient nutrient in diet
- administer as supplement
2) Change cook habit
3) Taking dietary habit
4) Decreased alcohol intake
5) Control chronic diarrhea
- help control folic acid
6) Blood transfussion
WHO HIGH RISK
TO GET ANEMIA?
Factors that raise your risk for anemia include:
-diet low in iron, vitamins, or minerals
- Blood loss from surgery or an injury
- Long-term infections
- A family history of inherited anemia,
Sickle cell anemia
Thalassemia
NURSING
CARE
PLAN
Nursing intervention rational
diagnosis
Activity intolerence 1) Monitor vital sign to 1) PT experiencing activity
RT evaluate tolerance to intolerance have
Tissue hypoxia and activity tachycardia , increased
dyspnea respiratory rate
2) To decrease the amount
2) Assist pt with self care of energy expand by the
activity as needed pt
3) Restrict the ADL of 3) To reduce the energy
the pt
4) Plan activity 4) Promote gradual return to
progression with pt normal activity level and
improved muscle tone
without fatigue
5 ) provide assistance 5 ) may help self
with activities and esteem enchance
ambulation as when pt do some
necessary things for self
6 )elevate head of bed 6) Enhance lung
as tolerated expansion to maximize
oxygenation Of cellular
uptake
7) Enhanced rest to lower
7) Recommend quiet body oxygen
atmosphere , bed rest if requirement
indicated
8) To conserve limited
8)Identify and implement energy and prevent
energy saving technique fatigue
eg: sit while doing
activities
9) Administer oxygen as 9) To anemic pt does not
order to relieve dyspnea have enough Hb to
carry oxygen to vital
organ
Nutrition 1. Assess the elasticity 1. to see decreases of nutrition
imbalanced less skin of the patient to
than body
requirement RT 2. Consult a dietation 2. to provide diet instruction
to disease
process or lack 3. Encourage patient to 3. to maintain nutrition in the
of knowledge of eat in small amount body
adequate but frequent
nutrition
4. Assess patient like
and dislike appetite 4. to recommendation of
and condition appropriate diet.
5. Discuss with the
patient on type of
diet suitable for 5. to patient decide on type of
himself diet with nurse advise
6. Encourage
patient to eat by 6. to provide
seeing comfort, comfort
food serving environment that
attractively can increase
appetite.
Risk of fall RT to 1. Assess the risk 1. to provide
weakness and the fall of the comfort
dizziness patient environment that
can increase
2. Assess patient to 2. to decreases the
changing high risk of fall
position
3. Make sure the 3. to the patient for
bell always easy the patient
nearest call nurse when
need help
4. Always keep the 4. to prevent
floor dry and patient to fall
put sign of ‘wet
floor’ to prevent
patient to fall
5. Make sure the 5. to prevent patient
side rail always to fall and support
up patient from fall
6. Always lower the 6. to easy the
bed patient moved
7. Tidy up all the 7. to easy patient
equipment to moved
give comfortable
environment to
easy patient
moved
8. Make sure all 8. to avoid patient
item is easy to fall
patient reach such
as chair and
Cupboard
9. Wear suitable 9. to avoid slipper
shoes
10. Encourage patient 10. To reduce energy
to rest and reduce use by the patient
the movement the
patient.
GROUP MEMBER
NUYAH
JUNAIDAH
MOHD HISYAM
MAILIN
NUR NADIAH
GROUP 2
