The document discusses anemia, highlighting its prevalence, particularly in India, where statistics indicate that half of Indian infants are anemic. It classifies various types of anemia, including iron deficiency, megaloblastic, and hemolytic anemias, detailing causes, symptoms, treatments, and investigations necessary for diagnosis. Supportive measures such as transfusions, nutritional interventions, and in some cases, surgical options like splenectomy are recommended to manage severe anemia.

2. PRESENTED BY
SMITA MANJUSHA DAS
M.SC(N) 1ST YEAR

4. INTRODUCTION
Blood formation begins in
the 4th week of gestation.
Anemia is a major killer in
India.
Statistics reveal that every
second Indian infant is
anemic

6. DEFINITION
Anemia (An-
without, emia -
blood)is a decrease
in the RBC count,
hemoglobin and/or
Hematocrit values
resulting in a lower
ability for the blood
to carry oxygen to
body tissues .

7. CONT...

10. POOR SOCIOECONOMIC STATUS

11. ILLETERACY

12. MULTIPARITY

13. TEEN AGE PREGNANCY

15. NUTRITIONAL DEFICIENCY
IMPAIRED RBC PRODUCTION

16. HEMOLYSIS
ABNORMAL Hb
SYNTESIS
G-6-P-D
DEFICIENCY
RBC
STRUCTURAL
DEFECT
INFECTION-
Malaria, kalA -zar
Drugs- phenytoin,
primaquine
LEAD POISONING
BURNS
SPLENOMEGALY

17. INCREASED BLOOD LOSS
ACUTE CHRONIC
TRAUMA
EPISTAXIS
LEUKEMIA
HEMOPHILIA
HOOKWORM
BLEEDING
PILES
CHRONIC
DYSENTRY

18. BONE MARROW DEPRSSION
PRIMARY
CAUSE
SECONDARY
CAUSE
•HYPOPLASIA
•APLASIA
•INFECTION
•NEPHRITIS
•T.B
•LIVER DISEASE
•HYPOTHYROIDISM

21. CLASSIFICATION

22. TYPES OF ANEMIA

23. Normochromic, normocytic
anemia
These include:
 anemias of chronic disease
 hemolytic anemias
 anemia of acute hemorrhage
 Aplastic anemias
TYPES OF ANEMIA

24. CONT..
Hypochromic, microcytic
anemia
These include:
 iron deficiency anemia
 Thalassemia
 anemia of chronic diseases

25. CONT..
Normochromic, macrocytic
anemia
These include:
 vitamin B12 deficiency
 folate deficiency

26. TYPES OF ANEMIA
Based on clinical picture-
 Iron deficiency anemia.
 Megaloblastic anemia.
 Pernicious anemia.
 Hemorrhagic anemia.
 Hemolytic anemia.
-Thalassemia anemia
-Sickle cell anemia
 Aplastic anemia

27. TYPES OF ANEMIA
Iron deficiency anemia
♣ excessive loss of iron .
♣ Women are at risk. ----
For menstrual blood and
growing fetus.

28. CONT..
Megaloblastic anemia
♣ Less intake of vitamin B 12
and folic acid.
♣ Red bone marrow produces
abnormal RBC.
e.g. cancer drugs
Pernicious anemia
♣ Inability of stomach to absorb
vitamin B 12 in small intestine.

29. TYPES OF ANEMIA
Hemorrhagic anemia
♣ Excessive loss of RBC through
bleeding, stomach ulcers,
menstruation
Hemolytic anemia
♣ RBC plasma membrane
ruptures.
♣ may be due to parasites,
toxins, antibodies.

30. CONT..
Thalassemia
♣ Less synthesis of hemoglobin
.Found in population of
Mediterranean sea.
Sickle cell anemia
♣ Hereditary blood disorder,
characterized by red blood cells that
assume an abnormal,
rigid, sickle shape.
Aplastic anemia
♣ destruction of red bone marrow .
♣ caused by toxins, gamma radiation.

32. PATHOPHYSIOLOGY

33. PATHOPHYSIOLOGY

34. SIGNS & SYMPTOMS

35. SYMPTOMS
Common symptoms of anemia
Easy fatigue and loss of energy
Unusually rapid heart beat,
particularly with exercise
Shortness of breath and
headache, particularly with
exercise

36. CONT..
A tingling, "pins and needles"
sensation in the hands or feet
Lost sense of touch
Clumsiness and stiffness of
the arms and legs
Dementia
Hallucinations and
schizophrenia

38. SIGNS OF ANAEMIA
 Brittle nails

39. KOILONYCHIA (SPOON SHAPED NAILS)

40. ATROPHY OF THE PAPILLAE OF
THE TONGUE

41. ANGULAR STOMATITIS

42. BRITTLE HAIR

43. DYSPHASIA

44. PLUMMER VINSON/ KELLY
PATTERSON SYNDROME
PVS sufferers often complain
of a burning sensation with the
tongue and oral mucosa, and
atrophy of lingual papillae
produces a smooth, shiny, red,
dorsum of the tongue.

45. WHITE CONJUNCTIVA

47. INVESTIGATIONS

48. Volume of packed cells i.e. the
Hematocrit
Hemoglobin concentration
Red cell concentration per unit
volume.
CBC
All serum vitamins
Bone marrow study
INVESTIGATIONS

50.  Shock
 CCF
 Cardiomegaly
 Systemic and local infection
 Growth retardation
 Mental retardation
 Decrease attention span
 Delayed puberty

52.  Initial treatment begins with
careful assessment of the signs
and symptoms of the anemia that
indicate therapy

53.  Supportive measures, such as
 supplemental oxygen
 fluid replacement
 and bed rest or activity
restriction for fatigue

54.  Transfusion with packed RBCs
(PRBC) is the universal treatment
for most individuals with severe
acute anemia
 If transfusion is indicated, the
packed RBC (PRBC) dose is 10-15
mL/kg over 3-4 hours. The rate of
transfusion can be modified
according to the clinical situation.

55. .
 Splenectomy is occasionally
considered in persons with
autoimmune hemolytic anemia
that is refractory to medical
treatment.
 Bone marrow transplantation

56.  Prednisolone decreases autoimmune
reactions, possibly by suppressing key
components of the immune system.
Methylprednisolone (Depo Medrol,
Medrol, Solu-Medrol)
 This agent is used for initial
management of acute hemolytic
anemia.
 Intravenous methylprednisolone is
recommended when the most rapid
and reliable treatment of hemolytic
anemia is required.

57. CONT…
Complimentary parasite control
measures
 Anti-helminthic therapy with 400 mg
of single dose of albendazole is given
to eliminate hook worms before the
initiation of iron and folic acid
therapy.
 Child -
<2yrs-200mg/day single dose

58. TREATMENT FOR 6-24 MONTHS
Dosage Birth-
weight
category
Duration
12.5 mg
iron + 50 ug
folic acid
daily
Normal
Low birth
weight
(<2500 g)
6-24 months of
age
2-24 months of
age

59. GROUP DOSAGE/day
Children 2-5 years 20-30 mg iron
Children 6-11 years 30-60 mg iron
Adolescents and adults 60 mg iron
TREATMENT OF MILD&MODERATE

60. TREATMENT OF SEVERE ANEMIA
AGE GROUP DOSE DURATION
<2 years 25 mg iron + 100-
400 ug folic acid
daily
3 months
2-12 years 60 mg iron + 400
ug folic acid daily
3 months
Adolescents and
adults, including
pregnant women
120 mg iron + 400
ug folic acid daily
3 months

62. DIAGNOSIS
 Imbalanced Nutrition Less Than Body
Requirements related to inability to absorb
nutrients associated with biological factors as
evidenced by less than weight according to
age
GOAL
To maintain the nutritional status
INTERVENTIONS

63.  Impaired Gas Exchange
May be related to
 Decreased oxygen-carrying
capacity of the blood, reduced
RBC life span/premature
destruction, abnormal RBC
structure; sensitivity to low
oxygen tension (strenuous
exercise, increase in altitude)

64. Possibly evidenced by
 Dyspnea
 Confusion
 Use of accessory muscles
 Restlessness
 Tachycardia
 Cyanosis (hypoxia

65. Acute Pain
Nursing Diagnosis
 Acute Pain
May be related to
 Intravascular sickling with localized stasis,
occlusion, and infarction/necrosis
 Activation of pain fibers due to deprivation of
oxygen and nutrients, accumulation of
noxious metabolites

66. Possibly evidenced by
 Localized, migratory, or more generalized
pain, described as throbbing, gnawing, or
severe and incapacitating; affecting
peripheral extremities, bones, joints, back,
abdomen, or head (headaches
recurrent/transient)
 Decreased ROM, guarding of the affected
areas
 Facial grimacing, narrowed/self-focus

70.  Dutta Parul, “pediatric nursing’’,2nd edition: New Delhi,
jaypee publication,(2009)
 Ghai O.P, “Essential pediatrics’’,6th edition: New Delhi,
CBS Publication,(2004)
 Kyle Terri, “Essential of pediatric nursing’’,1st edition :
New Delhi, wolter kluwer publication,(2009)
 Siddhartha and Brunner, “medical surgical
nursing”:12th edition , New Delhi, wolter kluwer
publication,(2009)
 www.google.com
 www.anemia.co.in
 www.anemia slideshare.com

71. THANK YOU