Monitoring the WBC is important because changes in the result of WBC will help in diagnosing infections. Healthy adult hematocrit values are generally between 38.3% and 48.6% for men and 35.5% and 44.9% for women. D. Elevated indirect bilirubin. Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Minimum hemoglobin levels are associated with fatigue while hospitalized and may help identify clients for interventions to address anemia-related fatigue (Prochaska et al., 2017). (https://www.cancer.gov/publications/fact-sheets?msclkid=7446ef3fa9e111ec86449ced5f55f9e4), (https://www.merckmanuals.com/home/blood-disorders/spleen-disorders/enlarged-spleen?msclkid=46277053a9e211ecaa9aaec74a1acaf8), Pathology & Laboratory Medicine Institute (R. Tomsich). Have them prioritize and complete the most important tasks when energy reserves are highest. It is critical to compare serial laboratory values to evaluate the clients progression or deterioration and identify changes before they become life-threatening. Policy. Anemia is an extremely common disease affecting up to one-third of the global population. Hello , Instruct and teach the patient about the energy-conservation techniques that he or she may use. As an Amazon Associate I earn from qualifying purchases. Women: 12.0 to 16.0 g/dL or 120 to 160 g/L. Assess and implement additional treatments for hypoxia if appropriate. In severe cases, blood transfusions may be necessary. Patient will identify factors that aggravate feelings of tiredness and weakness. All Rights Reserved. d) Walk for a minute or two in a room daily. Smaller increase hepatic tumor, hepatotoxic drugs, hepatitis, bone tumor, new bone growth, rheumatoid arthritis, Piagets disease, MI, C. Interventions for a Patient with an Elevated Value check for S&S of liver or bone disease, check patients medication list for liver toxic medications, IV Albumin can increase the value by 5 10 times normal, NV: 0.1 - 1.2 mg/dlCritical Values Adult > 12 mg/dl, Increased Level of Conjugated (Direct Bilirubin) gallstones, extra hepatic duct obstruction, extensive liver metastases, Increased Level of Unconjugated (Indirect) Bilirubin hepatitis, cirrhosis, neonatal hyperbilirubinemia, transfusion reaction, Treatment low protein diet for patients with liver disease, check skin & sclera for jaundice, Interventions for Decreased Values high protein diet if not in liver failure, assess patient for ascites & peripheral edema, transfuse with albumin as orderedIncreased, Intervention for Increased Value Rehydrate the patient with oral or IV fluids, NV: 70 - 110 mg/dlCritical Values < 40 or > 400 mg/dl, Decreased Values insulinoma, hypothyroidism, liver disease, insulin overdose, starvation, 1. A low hemoglobin level may be a sign of several conditions, including different kinds of anemia and cancer. With over 200 care plans covering the most common medical-surgical nursing diagnoses and clinical problems, this book reflects the latest evidence-based guidelines and national and international treatment protocols. 4. Yes, Guideline developed by participants without relevant financial ties to industry? Prevention of infections is made easier with the use of these precautions. Agarwal R. Iron deficiency anemia in chronic kidney disease: Uncertainties and cautions. Advise the patient to refrain from eating raw fruits, raw vegetables, and uncooked meat. Assess and monitor laboratory values.Low hemoglobin, hematocrit, platelet count, and alterations in PT/aPTT levels can signal issues with bleeding. Learn how your comment data is processed. Desired Outcome: The patient will have normal platelet levels with the absence of bleeding, bruising and petechiae. e) Walk through the length of the house, adding steps until the patient reaches the outdoors, conserving energy when returning. B. Dyspnea. Guideline source: American Gastroenterological Association, Systematic literature search described? Nursing Diagnosis Risk for bleeding related to low iron and abnormal RBC production as evidenced by low hemoglobin, hematocrit, and platelets. Same as EosinophilsDecreased Values - allergic reaction, hyperthyroidism, stressIncreased Values - Myeloproliferative diseases (cancer), leukemia, inflammatory process, healaing process, post surgery, asthma, cold. Red blood cells live about 120 days in your bloodstream. Assess vital signs, respiratory and cardiovascular systems, and level of consciousness. Inadequate blood flow can slow peristalsis and digestion of the intestines. 3. Sometimes, women have low hemoglobin levels when they have their periods. Monitoring the patients response to the activities and interventions will serve as a guide for the optimal progression of the activity and condition. To prevent the spread of infectious diseases. Ecchymosis is most common in anemia because blood vessels that are weak ruptures and results into ecchymosis. To improve the bloods ability to carry oxygen (i.e., oxygen-carrying capacity). Clinical manifestations of low hemoglobin levels include the following: There are various factors that can affect the hemoglobin levels in the patients body, and they are classified according to the following: Certain conditions or risk factors predisposes a patient to develop low hemoglobin levels. Long-term needs, and who is responsible for actions to be taken. Kumar A, Sharma E, Marley A, et al. A balance period of rest is important to help the patient have a complete desired activity without increasing the patients fatigue levels. Assist the patient in prioritizing activities and establishing balance between activity and rest that would be acceptable to the patient. Ask the patient and the family members about their knowledge about the condition, the disease process, possible causative factors, and treatment. Nursing care plans: Diagnoses, interventions, & outcomes. brings his wealth of experience from five years as a medical-surgical nurse to his role as a nursing instructor and writer for Nurseslabs, where he shares his expertise in nursing management, emergency care, critical care, infection control, and public health to help students and nurses become the best version of themselves and elevate the nursing profession. For example, if your hemoglobin levels are low, your healthcare provider may do tests that reveal you have iron-deficiency anemia. Anemia can be short or long-term and can range from mild to severe cases. Several common conditions associated with IDA can be diagnosed noninvasively, before or after endoscopy. Pyridoxine may be useful in the treatment of certain clients with sideroblastic anemia, even though this is not a deficiency disorder. Advise and assist the patient when planning the schedule for his or her daily activities and stress the importance of frequent rest periods. In conditions wherein the hemoglobin levels are low, this would result in lower oxygen concentration in the blood and tissues thereby inhibiting the body from accomplishing normal physiology and processes. Assess the patients oxygen saturation.Activity intolerance and fatigue may be precipitated by decreased oxygen saturation. The proper use of nutritional supplements should be explained to the patient and his/her family, as excessive intake will not help to improve anemic symptoms. What is the hemoglobin level of a patient with anemia? She takes the topics that the students are learning and expands on them to try to help with their understanding of the nursing process and help nursing students pass the NCLEX exams. EPO stimulates RBC production, and the effect is an increase in reticulocyte count. Otherwise, scroll down to view this completed care plan. These values may differ slightly from one medical practice to another. They may recommend you try to follow an iron-rich diet. Nursing Care Plan for: Activity Intolerance, Anemia, Low Hemoglobin, Sickle Cell Anemia, Iron Deficiency, Pernicious, Aplastic Anemia, Folic Acid Deficiency, and Thalassemia. to maintaining your privacy and will not share your personal information without This article is the best and easy to understand. It is composed of amino acids that form a single protein called globin, and a compound called heme, which contains iron atoms and the red pigment porphyrin. Patient will discuss and demonstrate interventions to prevent bleeding. St. Louis, MO: Elsevier. Some error has occurred while processing your request. Hullo, I am a student at the Aga Khan University in Uganda, Kampala doing BScM. Anemia is not a specific disease state but an underlying disorder and the most common hematologic condition. Range of motion ROM) exercises is important to patients with activity intolerance because ROM exercise will strengthen the muscle and joints of the patient. I am a student nurse from Kenya this article is so helpful Buy on Amazon, Silvestri, L. A. 4. include a rationale for each nursing intervention. Instruct the patient to practice deep breathing exercises. Am a nursing student Maseno university Kenya. Nursing Diagnosis: Activity Intolerance related to low hemoglobin and imbalance between oxygen supply and demand secondary to pernicious anemia. Instruct the patient to consume iron-rich foods to help build-up hemoglobin stores. For women, a severe low hemoglobin level is 12 gm/dL. Opportunistic infections may occur in patients with a weakened immune system. You may have low levels of iron. The AGA also suggests endoscopy in premenopausal women with IDA because malignancy is diagnosed in 1% of this population. Anemia epidemiology, pathophysiology, and etiology in low- and middle-income countries. She received her RN license in 1997. Nielsen OH, Ainsworth M, Coskun M, Weiss G. Management of Iron-Deficiency Anemia in Inflammatory Bowel Disease: A Systematic Review. Nursing Diagnosis: Risk for Bleeding related to loss of red blood cells, secondary to anemia. Nursing diagnoses handbook: An evidence-based guide to planning care. Advise and educate the patient to eat foods rich in iron, folic acid, and vitamin B12. Generally speaking, a balanced diet with a focus on important nutrients is the best way to maintain healthy red blood cells and hemoglobin. A low hemoglobin level means the patient cannot transport adequate oxygen to the different body organs and tissues, causing the patient to feel weak, tired, and easily fatigued. And seeing a hematologist for suspected or existent blood issues is the best way to get an accurate diagnosis. Anemia is usually discovered and quantified by measurement of the RBC count, hemoglobin concentration, and hematocrit (Maakaron & Besa, 2021). Oral iron supplementation should be provided for most patients with iron deficiency. Low hemoglobin counts associated with diseases and conditions. Oxygen powers your cells and gives you energy. doi: 10.1111/hdi.12561. However, the most typical manifestation is activity intolerance. Your body produces red blood cells and white blood cells in your bone marrow. The Hb determination is part of a complete blood cell count. Decrease in the reticulocyte count. They are: On top of this, certain people are prone to develop low hemoglobin levels due to: Complications of low hemoglobin levels may lead to various health issues such as: Diagnosing low hemoglobin levels and anemia would include a variety of techniques, some of which are: Treatment protocols and approaches for patients with low hemoglobin include a variety of techniques such as: Nursing Diagnosis: Fatigue related to low hemoglobin secondary to iron deficiency anemia as evidenced by dyspnea, inability to maintain usual level of physical activity, increased rest requirements, and patients report of fatigue and lack of energy. doi: 10.1136/bmjgast-2021-000759. Medicine (Baltimore).