What is blood ?
Blood is a combination of plasma (watery liquid) and cells
that float in it. It is a specialized bodily fluid that supplies
essentials substances and nutrients, such as sugar,
oxygen, and hormones to our cells, and carries waste away
from those cells
Types of blood cells
Red blood cells - also known as RBCs or
erythrocytes. These are the most abundant
cells, and contain hemoglobin (Hb or
Hgb). Hemoglobin is a protein which contains
iron; it transports oxygen from the lungs to
body tissues and cells. 97% of a human's red
blood cell's dry content is protein.
White blood cells (leukocytes) - these are the
cells of our immune system; they defend the
body against infections and foreign materials.
Platelets (thrombocytes) - are involved in the
clotting (coagulation) of blood. When we bleed
the platelets clump together to help form a
• Anemia is a condition in which the hemoglobin
concentration is lower than the normal; it reflects the
presence of fewer than the normal number of erythrocytes
within the circulation.
• As a result, the amount of oxygen delivered to the body
tissues is also diminished.
• Anemia is not a specific disease state but a sign of an
underlying disorder. It is by far the most common
Results from defective
Results from RBC loss
Results from RBC
Vitamin B12 deficiency (megaloblastic)
Folate deficiency (megaloblastic)
Decreased erythropoitin production
Bleeding from GI
• Iron deficiency anemia typically results when the intake of
dietary iron is inadequate for hemoglobin synthesis.
• Iron deficiency anemia is the most common type of
anemia in all age groups, and it is the most common
anemia in the world.
• The most common cause of iron deficiency anemia in
men and women is bleeding from ulcers gastrirtis,
inflammatory bowel disease, or GI tumors. The most
common causes of IDA in premenopusal woman are
menorrhagia ( ie, excessive menstrual bleeding) and
pregnancy with inadequate iron supplementation. Other
causes include iron malabsorption, as is seen after
( female 8.9-30.4 umol/l)
( male 11.6-30.4 umol/l)
• Correction of the underlying cause, iron supplements
• Ferrous phosphate, ferrous
• Administer small dose
Patient education ( taking oral iron
• Take iron on an empty stomach ( 1 hr before or 2 hrs after
the meal). Iron absorption is reduced with food, especially
• To prevent GI distress, the following schedule may work
better if more than one tablet a day is prescribed. Start
with only one tab/day for a few days, then increase to 2
tab/day, then 3 tab/day. This method permits the body to
adjust gradually to the iron.
• Increase the intake of vit C , to enhance iron absorption.
• Eat foods high in fiber to minimize problems with
• Remember that stool will become dark in color.
• Sickle cell anemia is a severe hemolytic anemia results
from inheritance of the sickle hemoglobin gene.
• The sickle hemoglobin (HbS) acquires a crystal-like
formation when exposed to low oxygen tension.
of the bones
of face and
Sings and symptoms:
pain in the joint
• Hgb—men 14-18g/dl, women 12-16g/dl
• Platelet count—150,000-350,000/100ml 0f blood.
• Haematocrit – packed cell volume (PCV).
• Bone marrow puncture
long term RBC
NURSING DIAGNOSIS AND
For all anemic patients
Diagnosis: Activity intolerance related to
poor tissue oxygenation.
Diagnosis: Pain related to joint