Nanda - Nursing Care Plan

Nursing Interventions for Anemia

Pediatric Care Plan Anemia

Anemia is a clinical condition in which total number of red blood cells or the quantity of hemoglobin in blood declines than the normal level so the oxygen binding ability of hemoglobin is decreased. Women are at higher risk of developing anemia than men. People who have other diseases such as cancer have a higher tendency to develop anemia. Anemia can become a very serious condition which can be dangerous. Anemia can also be acute or chronic in nature.

Hemoglobin present inside the red blood cells normally carries oxygen from lungs to the tissues and anemia causes hypoxia in organs. As all human cells are dependent upon oxygen for survival, anemia can lead to a wide variety of symptoms depending upon degree of destruction caused. There is a relationship between anemia and the kidneys, bone marrow and nutritional deficiencies in the body. When the kidneys are not working well or you are malnourished, this will affect your red blood cell count. Since red blood cells are made in the bone marrow the health of bone marrow is very important.


A complete blood count is typically used for the diagnosis of anemia. Apart from determining the number of red blood cells and hemoglobin levels automatic counters also measure the size of red blood cells by using flow cytometry which gives a clear picture of anemia. Examination of a stained blood smear under microscope also gives a clear cut idea about this disease. Reticulocyte count and kinetic approach are very commonly used in diagnosis. A recticulocyte count is actually a quantitative measure of bone marrow's production of new red blood cells. If automated blood count is not available then reticulocyte count can be taken into consideration for disease diagnosis.

Nursing Interventions for Anemia

1. Adequate tissue perfusion
  • Monitor vital signs, capillary refill, skin color, mucous membranes.
  • Raising the head position in bed.
  • Examine and document the presence of pain.
  • Observation of verbal response delay, confusion, or anxiety.
  • Observing and documenting the existence of the cold.
  • Maintain ambient temperature to keep warm the body needs.
  • Provide oxygen as needed.

2. Supporting children remain tolerant of activity
  • Assess the child's ability to perform physical activities in accordance with the conditions and development of children assignment.
  • Monitoring vital signs during and after activity, and noted a physiological response to activity (increased heart rate increased blood pressure, or rapid breathing).
  • Provide information to the patient or family to stop doing the activity, if any symptoms of increased heart rate, increased blood pressure, rapid breathing, dizziness or fatigue).
  • Provide support to the child to perform daily activities in accordance with the child's ability.
  • Teach the parents of patients, the technique gives reinforcement to the participation of children in the home.
  • Make a schedule of activities with the children and families by involving other health team.
  • Explain and provide recommendations to the school about the child's ability to perform the activity, the ability to monitor activity on a regular basis and explain to parents and schools.

3. Adequate nutritional needs
  • Allowing children to eat foods that can be tolerated child, plan to improve the quality of nutrition at child's appetite increases.
  • Give food accompanied by nutritional supplements to improve nutrient intake.
  • Allowing children to be involved in the preparation and selection of food.
  • Evaluate the child's weight every day.