Nursing Care Plan for Anemia

Posted on by Soumya Ranjan Parida
Nursing Care Plan for Anemia

Comprehensive Nursing Care Plan for Anemia

Nursing Style Approach
Evidence-based, visually organized continuous page for easy PDF export.
1. Decreased Oxygen-carrying Capacity
Assessment:
  • Fatigue, pallor, tachycardia, dyspnea on exertion
  • Decreased SpO2 in severe anemia
  • Weak pulses, dizziness, new or worsening angina in cardiac patients
  • Lab: Low hemoglobin/hematocrit, low RBC count
  • Altered mental status in severe cases
Diagnosis:   Decreased oxygen-carrying capacity related to reduced hemoglobin secondary to anemia.
Goal:   The patient will maintain adequate tissue oxygenation as evidenced by normal vital signs, absence of dyspnea, and appropriate mental status.
Planning:
  • Monitor patient for signs of hypoxia
  • Maintain close monitoring during periods of activity and rest
  • Ensure readiness to intervene if oxygenation deteriorates
Interventions:
  • Monitor vital signs and SpO2 at least every 4 hours; increase frequency if status worsens.
  • Assess for dyspnea, mental status changes, chest pain, restlessness.
  • Provide supplemental oxygen if ordered, or as condition indicates.
  • Promote bed rest or minimize exertion during periods of acute anemia.
  • Elevate the head of bed to improve respiratory effort.
  • Collaborate with the healthcare team for transfusion if indicated (e.g., in severe anemia).
  • Educate the patient/family to immediately report increased shortness of breath or chest pain.
Evaluation:
  • Patient maintains SpO2 ≥ 94% on room air or as baseline
  • Vital signs stable; no new neurologic or cardiac symptoms
  • Patient verbalizes understanding of when to alert staff
2. Activity Intolerance
Assessment:
  • Reports of weakness/fatigue limiting ADLs
  • Increased heart rate, shortness of breath with minimal exertion
  • Muscle weakness, dizziness, low endurance
  • Pallor noted with exertion
Diagnosis:   Activity intolerance related to decreased oxygen supply to tissues secondary to anemia.
Goal:   Patient will participate in activities at a tolerance level, with vital signs within target range and minimal complaints of fatigue.
Planning:
  • Assess tolerance to current activity level
  • Develop gradual, individualized activity plan
  • Reinforce energy conservation techniques
Interventions:
  • Assess baseline activity tolerance and limitations daily.
  • Instruct patient on pacing activities and using rest periods between tasks.
  • Assist with ADLs as needed during periods of pronounced fatigue.
  • Monitor vital signs before, during, and after activity.
  • Encourage use of energy conservation techniques (sitting while grooming, organizing supplies).
  • Gradually increase activity level as tolerated, with incremental goals.
  • Provide supportive devices if indicated (walker, grab bars to prevent falls).
Evaluation:
  • Patient able to perform ADLs/participate in rehabilitation within agreed limitations
  • Vital signs remain stable post-activity
  • Fatigue reported at manageable levels
3. Fatigue
Assessment:
  • Persistent physical and mental exhaustion
  • Patient verbalizes tiredness, inability to perform tasks
  • Irritability, decreased concentration
  • Pale skin, low hemoglobin on labs
Diagnosis:   Fatigue related to reduced oxygenation and metabolic demands exceeding supply secondary to anemia.
Goal:   Patient will report improvement in fatigue and demonstrate use of energy-saving strategies.
Planning:
  • Identify periods of highest energy for patient
  • Schedule activities during optimal energy periods
  • Incorporate rest into routine
Interventions:
  • Assess severity and impact of fatigue each shift.
  • Encourage regular short rest periods, especially before and after activity.
  • Assist patient in setting priorities and delegating less urgent tasks.
  • Promote proper sleep hygiene (dark room, limit caffeine/stimulants in the evening).
  • Provide relaxing diversions (music, reading) that don’t require exertion.
  • Ensure adequate hydration and nutrition to support energy levels.
  • Teach patient/family to recognize signs of overexertion and adjust activity accordingly.
Evaluation:
  • Patient verbalizes improved sense of energy
  • Patient utilizes recommended fatigue management techniques
4. Imbalanced Nutrition: Less than Body Requirements
Assessment:
  • Diet history reveals inadequate iron, B12, or folic acid intake
  • Weight loss or failure to gain/maintain weight
  • Pale skin, glossitis, angular cheilosis
  • Diminished appetite or early satiety
Diagnosis:   Imbalanced nutrition: Less than body requirements related to anemia and insufficient nutrient intake/absorption.
Goal:   Patient will demonstrate improved nutritional status through appropriate food choices and stable weight.
Planning:
  • Identify and address underlying causes of poor nutrition
  • Collaborate with dietitian for meal planning
  • Educate on anemia-friendly diets
Interventions:
  • Assess daily dietary intake of iron, B12, folic acid.
  • Collaborate with dietitian to tailor a nutrient-rich, anemia-specific meal plan.
  • Encourage intake of iron-rich foods (leafy greens, red meat, legumes, fortified grains).
  • Provide oral supplements/vitamins as ordered; monitor adherence.
  • Educate on enhancing iron absorption (consume vitamin C-rich foods with iron sources; avoid tea/coffee with meals).
  • Monitor weight, appetite, and any GI symptoms daily.
  • Respect cultural food preferences to promote meal compliance.
Evaluation:
  • Patient consumes recommended nutrients/food groups
  • Stabilization or improvement in weight and nutritional labs
5. Ineffective Tissue Perfusion
Assessment:
  • Cool, pale skin; slow capillary refill; weak pulses
  • Tachycardia, orthostatic hypotension
  • Altered mental status, confusion, or dizziness
  • Kidneys: oliguria or dark concentrated urine
Diagnosis:   Ineffective tissue perfusion related to decreased blood oxygen content secondary to anemia.
Goal:   Patient will show improved perfusion with vital signs and tissue parameters near baseline.
Planning:
  • Monitor for signs of decreased perfusion in all organ systems
  • Support oxygen delivery and cardiac output
  • Educate on preventive strategies
Interventions:
  • Monitor peripheral pulses, capillary refill, skin color and temperature every shift.
  • Assess neurologic status and mental alertness regularly.
  • Monitor intake and output, noting changes in urinary output pattern or color.
  • Watch for signs of angina, chest pain, or palpitations; notify provider promptly.
  • Administer IV fluids or blood products as ordered for severe anemia.
  • Teach patient to change positions slowly to prevent orthostatic hypotension and falls.
  • Educate on importance of maintaining hydration and reporting persistent dizziness.
Evaluation:
  • Patient maintains warm, pink extremities with adequate capillary refill
  • No new episodes of dizziness, syncope, or chest pain
6. Risk for Infection
Assessment:
  • History of neutropenia or immunocompromise in certain anemia types (e.g. aplastic or hemolytic), chronic disease, or therapy
  • Signs of infection: fever, malaise, localized redness/swelling
  • Poor wound healing
Diagnosis:   Risk for infection related to impaired host defenses secondary to anemia and/or its treatment.
Goal:   Patient will remain free from signs and symptoms of infection.
Planning:
  • Identify and monitor for early signs of infection
  • Reinforce protective strategies to patient/family
Interventions:
  • Monitor temperature and signs of infection every shift; report changes promptly.
  • Practice and teach strict hand hygiene before and after all patient contact.
  • Limit exposure to crowds and sick contacts when immune function is suppressed.
  • Provide mouth care with soft toothbrush; avoid oral trauma.
  • Assess IV sites, wounds, and mucous membranes for redness, swelling, or drainage daily.
  • Ensure proper food handling and safe food choices (avoid raw/undercooked foods if neutropenic).
  • Educate on signs/symptoms of infection to report and the importance of immunizations as recommended.
Evaluation:
  • No new signs of infection are present
  • Patient/family demonstrate good infection prevention behaviors
7. Impaired Oral Mucous Membrane
Assessment:
  • Pain, ulcerations, bleeding in the mouth
  • Pale, smooth, glossy tongue (atrophic glossitis)
  • Cracks at the corners of the mouth (angular cheilitis)
  • Loss of taste, difficulty chewing or swallowing
Diagnosis:   Impaired oral mucous membrane related to reduced tissue oxygenation/nutrient deficiencies secondary to anemia.
Goal:   Oral mucosa will remain/return to intact, moist, and pain-free status.
Planning:
  • Regularly assess and document oral condition
  • Promote environment conducive to healing and comfort
Interventions:
  • Assess oral cavity every shift for inflammation, ulceration, or bleeding.
  • Encourage gentle, frequent oral hygiene with non-abrasive products.
  • Use saline rinses to keep mouth moist and reduce bacteria.
  • Avoid spicy, acidic, rough, or hot foods and beverages that may irritate mucosa.
  • Encourage adequate fluid intake to maintain hydration of mucous membranes.
  • Apply moisturizing lip balm to prevent cracking and dryness.
  • Encourage use of a straw if swallowing is difficult, and refer to speech therapist if indicated.
Evaluation:
  • Oral mucosa remains pink, moist, and free from painful lesions
  • Patient tolerates oral intake without discomfort
8. Disturbed Thought Processes
Assessment:
  • Difficulty concentrating, forgetfulness, confusion
  • Patient/family notices changes in cognition and memory
  • Mood changes (irritability, apathy)
  • History of underlying cognitive impairment may be exacerbated
Diagnosis:   Disturbed thought processes related to reduced cerebral oxygenation secondary to anemia.
Goal:   Patient will demonstrate improvement in cognitive function and orientation.
Planning:
  • Monitor cognition baseline and fluctuations daily
  • Support patient orientation & mental stimulation
Interventions:
  • Assess mental status (orientation, short- and long-term memory, language skills) every shift.
  • Ensure optimal oxygen delivery (positioning, treat underlying anemia).
  • Reorient patient frequently and keep a clock/calendar visible at bedside.
  • Provide a calm, structured environment to minimize overstimulation and anxiety.
  • Encourage family involvement and presence for support and familiar stimuli.
  • Allow extra time for responses and simple, direct communication.
  • Collaborate with physician for further cognitive assessment or neuro consult as needed.
Evaluation:
  • Patient demonstrates improved cognition and orientation to person, place, and time
  • Decreased episodes of confusion and distractibility
9. Deficient Knowledge
Assessment:
  • Patient/family expresses lack of understanding about anemia, treatment, or symptom management
  • Demonstrates incorrect beliefs or nonadherence to therapy
  • Asks frequent questions regarding illness and recovery
Diagnosis:   Deficient knowledge related to lack of exposure or misinterpretation of condition and treatment plan.
Goal:   Patient/family will demonstrate accurate knowledge and adherence to the management plan.
Planning:
  • Identify patient’s current knowledge level
  • Develop targeted education interventions
Interventions:
  • Assess patient/family understanding and readiness to learn about anemia and therapies.
  • Use age-appropriate, culturally sensitive educational materials (handouts, diagrams).
  • Explain rationale for medications, supplements, and blood transfusions in simple terms.
  • Teach correct technique for oral iron supplementation (timing, with vitamin C, avoid calcium/antacids).
  • Discuss expected side effects and when to report them (dark stools, GI upset).
  • Encourage asking questions and provide reassurance to correct misconceptions.
  • Evaluate learning through teach-back or demonstration; reinforce information as needed.
Evaluation:
  • Patient/family accurately describes plan and demonstrates correct self-care
  • Improved adherence to medication and lifestyle recommendations
10. Risk for Bleeding
Assessment:
  • History of bleeding disorders or recent anticoagulant/antiplatelet use
  • Low platelet count on labs (in some anemia types)
  • Ecchymosis, petechiae, bleeding gums, hematuria
  • Heavy/prolonged menstrual bleeding
Diagnosis:   Risk for bleeding related to underlying disease process and/or reduced platelet function secondary to anemia.
Goal:   Patient will remain free of new or increased bleeding episodes.
Planning:
  • Monitor frequently for hemorrhagic complications
  • Patient/family understand bleeding precautions
Interventions:
  • Monitor for visible bleeding (urine, stool, skin, gums, nosebleeds) every shift.
  • Check laboratory values for platelets, PT/INR/aPTT regularly.
  • Avoid IM injections, arterial punctures, or other procedures that may provoke bleeding unless necessary.
  • Apply gentle pressure to venipuncture sites; use smallest gauge needles possible.
  • Encourage use of soft toothbrushes and electric razors; avoid sharp objects.
  • Educate on signs of internal bleeding (rapid pulse, hypotension, melena, coffee-ground emesis).
  • Consult provider immediately for unexplained bruising, hematuria, or uncontrolled bleeding.
Evaluation:
  • No new bruising, petechiae, or evidence of internal/external bleeding
  • Patient/family verbalizes and practices bleeding precautions
11. Ineffective Health Maintenance
Assessment:
  • Irregular follow-up or nonadherence to therapy
  • Lack of support network or difficulty accessing care/medications
  • Repeat admissions/ER visits for anemia symptoms
Diagnosis:   Ineffective health maintenance related to insufficient resources or knowledge deficits secondary to chronic anemia.
Goal:   Patient will demonstrate ability to manage anemia and maintain regular health-related behaviors.
Planning:
  • Identify challenges with self-management
  • Collaborate with case management/social work as needed
Interventions:
  • Assess barriers to adherence (cost, transportation, understanding, support).
  • Develop individualized teaching plan for medication, nutrition, and follow-up.
  • Link patient to case management/social services for resource access.
  • Encourage development of medication-schedule reminders (phone alarms, pill organizers).
  • Facilitate referrals as needed (nutrition, pharmacy, transportation assistance agencies).
  • Discuss importance of routine follow-up appointments and lab monitoring.
  • Engage family and caregivers as appropriate in the care plan and education.
Evaluation:
  • Patient attends scheduled visits, follows plan, and obtains necessary medications
  • Self-care behaviors improve and are sustained
12. Anxiety
Assessment:
  • Reports feeling worried or fearful about condition/prognosis
  • Restlessness, insomnia, tachycardia, irritability
  • Excessive questioning about future, treatments, or outcomes
  • Difficulty concentrating or making decisions
Diagnosis:   Anxiety related to diagnosis of anemia and uncertainty about health outcomes.
Goal:   Patient will report reduced anxiety and will demonstrate effective coping mechanisms.
Planning:
  • Assess anxiety triggers/expressions regularly
  • Individualize support and interventions for coping
Interventions:
  • Assess level of anxiety and patient’s understanding of anemia.
  • Encourage open expression of feelings; provide emotional support and active listening.
  • Provide up-to-date, clear information about diagnosis and treatment progress.
  • Teach and practice relaxation techniques (deep breathing, guided imagery, progressive muscle relaxation).
  • Allow involvement in care decisions and goal setting to increase self-control.
  • Offer reassurance; identify strengths and previous coping successes.
  • Refer to counseling, peer support groups, or spiritual care if needed.
Evaluation:
  • Patient expresses improved sense of tranquility and emotional control
  • Utilizes suggested coping and relaxation techniques confidently

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