Which instruction is beneficial for the nurse to provide to a patient diagnosed with pernicious anemia?

In this guide are five nursing diagnoses for anemia nursing care plans. Get to know the nursing assessment cues, goals, related factors, and interventions with rationale in this care plan guide.

Inhaltsverzeichnis Show

What is Anemia?
Nursing Care Plans
Recommended Resources
References and Sources
When teaching about pernicious anemia which explanation would the nurse provide the patient regarding the cause of this type of anemia?
Which treatment is likely to be planned for a patient who develops pernicious anemia?
Which foods will the nurse help the client with vitamin B12 deficiency to increase in the diet?
Which complication does the nurse observe in a client with vitamin B12 folic acid and iron deficiencies?

What is Anemia?

Anemia is the most common hematologic disorder. The hemoglobin level is lower than normal, reflecting a decrease in number or derangement in the function of red blood cells within the circulation. As a result, the amount of oxygen delivered to body tissues is also lessened.

Types of Anemia

Anemia may be classified in many ways:

In iron deficiency anemia, it is a hypochromic, microcytic type of anemia, resulting from inadequate iron supplementation, chronic blood loss seen in men and older women who have ulcers or GI tumors and younger women with heavy menstruation.
Aplastic anemia, on the other hand, is caused by damage to hematopoietic stem cells and the bone marrow. This causes a depression of all blood elements: (pancytopenia): red blood cells (anemia), white blood cells (leukopenia), and platelets (thrombocytopenia).
Pernicious anemia is caused by faulty absorption of vitamin B12 from the GI tract, which is required in the production of red blood cells.

Nursing Care Plans

Nursing care plan for clients with anemia includes: assess risk factors, decrease fatigue, maintenance of adequate nutrition, maintenance of adequate tissue perfusion, compliance with the prescribed treatment regimen, and be free from complications.

Here are five (5) nursing care plans (NCP) and nursing diagnoses for patients with anemia (aplastic, iron deficiency, cobalamin, pernicious):

Fatigue
Deficient Knowledge
Risk For Infection
Risk For Bleeding
Activity Intolerance

1. Fatigue

Fatigue

Nursing Diagnosis

Fatigue

Decreased hemoglobin and diminished oxygen-carrying capacity of the blood.

Possibly evidenced by

Exertional discomfort or dyspnea.
Inability to maintain usual level of physical activity.
Increased rest requirements.
Report of fatigue and lack of energy.

Desired Outcomes

Client will verbalize understanding on the use of energy conservation principles.
Client will verbalize reduction of fatigue, as evidenced by reports of increased energy and ability to perform desired activities.

Nursing Assessment and Rationales

1. Assess the specific cause of fatigue.
The specific cause of fatigue is tissue hypoxia from normocytic anemia; Other related medical problems can also compromise activity tolerance.

2. Assess the client’s ability to perform activities of daily living (ADLs) and the demands of daily living.
Fatigue can limit the client’s ability to participate in self-care and perform their role responsibilities in family and society, such as working outside the home.

3. Monitor hemoglobin, hematocrit, RBC counts, and reticulocyte counts.
Decreased RBC indexes are associated with the decreased oxygen-carrying capacity of the blood. It is critical to compare serial laboratory values to evaluate the client’s progression or deterioration and identify changes before they become life-threatening.

Nursing Interventions and Rationales

1. Assist the client in developing a schedule for daily activity and rest. Stress the importance of frequent rest periods.
Energy reserves may be depleted unless the client respects the body’s need for increased rest. A plan that balances periods of activity with rest periods can help the client complete desired activities without adding fatigue levels.

2. Educate energy-conservation techniques.
Clients and caregivers may need to learn skills for delegating tasks to others, setting priorities, and clustering care to use the available energy to complete desired activities. Organization and time management can help the client conserve energy and reduce fatigue.

3. Instruct the client about medications that may stimulate RBC production in the bone marrow.
Recombinant human erythropoietin, a hematological growth factor, increases hemoglobin and decreases the need for RBC transfusions.

4. Provide supplemental oxygen therapy as needed.
Oxygen saturation should be kept at 90% or greater.

5. Anticipate the need for the transfusion of packed RBCs.
Packed RBCs increase the oxygen-carrying capacity of the blood.

6. Refer the client and family to an occupational therapist.
The occupational therapist can teach the client about using assistive devices. The therapist also can help the client and family evaluate the need for additional energy-conservation measures in the home setting.

1. Fatigue

Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy.

Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use.
Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively.
NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales.
Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates.
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing.
Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans.
Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you.
Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023.
All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.

References and Sources

Recommended journals, reference books, and interesting articles about Anemia nursing care plans:

Badireddy, M., Baradhi, K. M., & Wilhite Hughes, A. (2021). Chronic Anemia (Nursing).
Butcher, H. K., Bulechek, G. M., Dochterman, J. M. M., & Wagner, C. M. (2018). Nursing interventions classification (NIC)-E-Book. Elsevier Health Sciences.
DeWit, S. C., Stromberg, H., & Dallred, C. (2016). Medical-surgical nursing: concepts & practice. Elsevier Health Sciences.
Dharmarajan, T. S., Pankratov, A., Morris, E., Qurashi, S., Law, G., Phillips, S., … & Norkus, E. P. (2008). Anemia: its impact on hospitalizations and length of hospital stay in nursing home and community older adults. Journal of the American Medical Directors Association, 9(5), 354-359.
Eichner, E. R. (2001). Fatigue of anemia. Nutrition reviews, 59(1), S17.
Hinkle, J. L., & Cheever, K. H. (2018). Brunner and Suddarth’s textbook of medical-surgical nursing. Wolters kluwer india Pvt Ltd.
Lucena, A. D. F., Laurent, M. D. C. R., Reich, R., Pinto, L. R. C., Carniel, E. L., Scotti, L., & Hemesath, M. P. (2019). Nursing diagnosis risk for bleeding as an indicator of quality of care for patient safety. Revista gaucha de enfermagem, 40.
Munch, T. N., Zhang, T., Willey, J., Palmer, J. L., & Bruera, E. (2005). The association between anemia and fatigue in patients with advanced cancer receiving palliative care. Journal of palliative medicine, 8(6), 1144-1149.
Mock, V., & Olsen, M. (2003, November). Current management of fatigue and anemia in patients with cancer. In Seminars in oncology nursing (Vol. 19, pp. 36-41). WB Saunders.
Sabol, V. K., Resnick, B., Galik, E., Gruber‐Baldini, A., Morton, P. G., & Hicks, G. E. (2010). Anemia and its impact on function in nursing home residents: What do we know?. Journal of the american academy of nurse practitioners, 22(1), 3-16.
Viana, M. B. (2011). Anemia and infection: a complex relationship. Revista brasileira de hematologia e hemoterapia, 33, 90-92.
Walter, T., Olivares, M., Pizarro, F., & Muñoz, C. (1997). Iron, anemia, and infection. Nutrition Reviews, 55(4), 111-124.
Williams, L. S., & Hopper, P. D. (2015). Understanding medical surgical nursing. FA Davis.

Paul Martin is a registered nurse with a bachelor of science in nursing since 2007. Having worked as a medical-surgical nurse for five years, he handled different kinds of patients and learned how to provide individualized care to them. Now, his experiences working in the hospital is carried over to his writings to help aspiring students achieve their goals. He is currently working as a nursing instructor and have a particular interest in nursing management, emergency care, critical care, infection control, and public health. As a writer at Nurseslabs, his goal is to impart his clinical knowledge and skills to students and nurses helping them become the best version of themselves and ultimately make an impact in uplifting the nursing profession.

When teaching about pernicious anemia which explanation would the nurse provide the patient regarding the cause of this type of anemia?

– Pernicious anemia is caused by a lack of intrinsic factor (IF) in the stomach, which causes B-12 deficiency. Intrinsic factor is a protein produced by the parietal cells of the gastric mucosa (stomach lining) that is necessary for the absorption of vitamin B-12 later on in the small intestine.

Which treatment is likely to be planned for a patient who develops pernicious anemia?

Pernicious anemia and other vitamin B12 deficiency anemia due to small intestinal malabsorption can be treated with an intramuscular B12 injection by your physician. High-dose oral vitamin B12 supplementation may be an effective option for some people with pernicious anemia as well.

Which foods will the nurse help the client with vitamin B12 deficiency to increase in the diet?

You must eat foods that contain vitamin B12, such as meat, poultry, shellfish, eggs, fortified breakfast cereals, and dairy products. Your body must absorb enough vitamin B12. A special protein, called intrinsic factor, helps your body do this.