mcn 2

• Anemia


  Common blood (RBC) disorder in children with deficient oxygen supply due to not having enough RBC's and hemoglobin
• Common types of anemia

  • Iron deficiency anemia
  • Megaloblastic anemia
  • Sickle cell anemia
  • Aplastic anemia
  • Hemolytic anemia
  • Cooley's anemia (thalassemia major)
• Iron deficiency anemia


  Not enough iron in the blood, iron is needed for the formation of hemoglobin and oxygen-carrying capacity
• Megaloblastic anemia


  Large RBC's due to lack of folic acid (folate anemia) or vitamin B12 (pernicious anemia), folic acid and vitamin B12 necessary to make RBC's
• Sickle cell anemia


  Inherited type characterized by abnormally shaped RBC's (S-shaped or crescent) resulting to sickling (not flexible) of RBC's, sickle cell crisis occurs when blood flow is obstructed due to sickling of cells resulting to ischemia or necrosis
• Aplastic anemia


  Failure of bone marrow to form or produce blood cells
• Hemolytic anemia


  Destruction of RBC's due to infection, chronic medical conditions, or certain medications
• Cooley's anemia (thalassemia major)


  Inherited type of anemia with abnormal RBC's and faulty synthesis of hemoglobin
• Main causes of anemia

  • Loss of red blood cells
  • Destruction of red blood cells
  • Inability to form or produce red blood cells
• Decreased RBC and hemoglobin levels may be due to

  • Genetic factors
  • Infections and certain chronic diseases
  • Certain drugs or medications
  • Lack of vitamins and minerals in the diet
• Risk factors for anemia

  • Diet low in iron, folic acid, vitamin B12, and other vitamins and minerals
  • Chronic illness such as infections, kidney or liver disease
  • Family history of anemia or other blood disorder
  • Premature or low birth weight
  • Poor nutrition during pregnancy
  • Early non-breastfeeding practice
  • Surgery or accident with severe blood loss
• Common signs and symptoms or clinical manifestations of anemia

  • Increased heart rate or tachycardia
  • Difficulty or shortness of breath
  • Headache
  • Irritability
  • Lack of energy
  • Easy fatigability
  • Dizziness and orthostatic hypotension
  • Jaundice
  • Sore or swollen tongue or gums
  • Enlarged spleen or liver
  • Poor wound and tissue healing
  • Irregular menstruation
  • Slow or delayed growth and development
• Treatment for anemia


  • Increase vitamins and minerals in diet, supplements may be given
  • Blood transfusions
  • Splenectomy or stem cells transplants
• Possible complications of anemia

  • Problems with growth and development
  • Joint pain and swelling
  • Poor tissue perfusion
  • Bone marrow failure
  • Leukemia or other cancers
• Nursing priorities of clients' problems/needs with anemia

  • Inadequate oxygenation
  • Fatigue and activity intolerance
  • Nutritional deficiencies
  • Medication and blood transfusion management
  • Health teachings and promotion of self-care skills
• Nursing interventions for anemia

  • Enhancing tolerance to activity and managing fatigue
  • Improving tissue perfusion and preventing risk for bleeding
  • Preventing risk for infection and promoting infection control
  • Assessing and monitoring for potential complications
  • Administering pharmacologic support and medical treatments
  • Monitoring laboratory and diagnostic procedures
  • Initiating health teachings and client/family education
• Coagulation disorders


  Inability of the body to control blood clotting, can result in either hemorrhage (too little clotting) or thrombosis (too much clotting)
• Common coagulation disorders resulting in bleeding/hemorrhage

  • Hemophilia
  • Von Willebrand disease
  • Vitamin K deficiency
• Hemophilia


  Inherited sex-linked (carrier of defective gene is female) bleeding disorder in males due to lack of clotting factor protein necessary for blood clotting
• Von Willebrand disease


  Inherited bleeding disorder due to lack of Von Willebrand clotting factor (VWF)
• Vitamin K deficiency


  Lack of vitamin K necessary for blood clotting mechanism, may result to bleeding problems, poor bone development, and cardiovascular problems
• Common coagulation disorders resulting in thrombosis

  • Prothrombin gene mutation
  • Factor V Leiden syndrome
  • Antithrombin III deficiency
• Prothrombin gene mutation


  Genetic disorder resulting in increased levels of clotting factors leading to too much blood clotting
• Factor V Leiden syndrome


  Genetic disorder resulting in overreacting of blood clotting protein (factor V Leiden) causing rapid or too much blood clotting
• Antithrombin III deficiency


  Genetic disorder resulting in lack of AT III necessary for regulating bleeding and clotting mechanisms
• Clinical manifestations with hemorrhage (too little clotting)

  • Easy and excessive bruising
  • Easy fatigability
  • Blood in urine, stool, or vomitus
  • Prolonged bleeding in ordinary cuts, wounds, injury, surgery, or dental works
  • Sudden nose bleeding
  • Sudden pain, swelling, and warmth in joints or muscles
  • Headache, vision problems
• Clinical manifestations with thrombosis (too much clotting)

  • Thrombus formation - stationary clots may cause obstruction in blood vessels
  • Embolus formation - wandering clots may travel and cause obstruction in lungs, brain, or other major organs in the body
• Common complications with hemorrhage

  • Anemia
  • Hypovolemic shock
  • Organ failure
  • Seizures
  • Coma (or even death)
• Common complications with thrombosis

  • Deep vein thrombosis (DVT) - thrombus lodged and obstructed deep veins in the body
  • Pulmonary embolism - embolus has traveled, lodged, and obstructed in lung capillaries
  • Heart attack or stroke
  • Recurrent pregnancy loss or stillbirth
• Treatment for coagulation disorders with bleeding problems

  • Medications to control bleeding
  • Ice/cold compression
  • Elevation of affected area
  • Complete bed rest
• Treatment for coagulation disorders with clotting problems

  • Anticoagulant therapy
  • Administering blood thinners (Heparin, Warfarin)
• Nursing priorities of clients' problems/needs with bleeding

  • Preventing bleeding and bleeding-related injuries
  • Promoting good tissue perfusion and skin integrity
  • Preventing fluid volume deficit
• Nursing interventions for bleeding problems

  • Assessing the risk for bleeding
  • Preventing fluid volume deficit and excessive bleeding
  • Preventing the risk for injury
  • Promoting skin integrity
  • Providing client/family education about bleeding precautions
• Nursing priorities of clients' problems/needs with thrombosis

  • Preventing pulmonary embolism
  • Management of pain
  • Promotion of circulation and good tissue perfusion
  • Prevention of complications
  • Client/family education and health teachings
  • Anticoagulant therapy
• Nursing interventions for problems with thrombosis


  • Promoting effective gas exchange
  • Enhancing peripheral tissue perfusion
  • Managing acute pain
  • Preventing risk for bleeding and injury
  • Assessing and monitoring for potential complications
  • Administering pharmacologic and medical treatments
  • Monitoring laboratory and diagnostic procedures
  • Initiating health teachings and client/family education
  • Providing perioperative care and support
• thrombus lodged and obstructed deep veins in the body

  Deep vein thrombosis (DVT)