Anemia is a condition whereby the body does not have adequate healthy red blood cells
Assignment Details: Anemia is a condition whereby the body does not have adequate healthy red blood cells to carry oxygen to all the body tissues and organs. Thus, anemia is a condition and not a diagnosis. This health condition is evidenced by fatigue/tiredness, syncope, respiratory distress/shortness of breath, The Center for disease control and prevention reported that there is about 3 million anemic individuals in the U.S, (www.nhlbi.nih.gov/health/anemia)
There are different types of Anemia:
Normocytic Anemia: which is often seen in individuals with chronic health conditions like kidney disease, multiple myeloma or acute situations like trauma, surgery and sepsis. The cell has normal size. Hypo-proliferative anemia is the most common, after bleeding is ruled out (Fedorowicz, 2023).
Symptoms: Usually vague or patient might not complain of any specific symptom.
Labs/Diagnosis: CBC with abnormal MCH, MCV, MCHC, Reticulocyte count, haptoglobin level, elevated indirect bilirubin. Coombs test is used for autoimmune cases. (Fedorowicz, 2023).
Treatment: Determined by the underlying cause of the anemia. In situations where the hematocrit is below 30%, recombinant Erythropoietin alfa or Darbepoetin may be indicated. Activity as tolerated per patient. (Dunphy et al, 2023)
Microcytic Anemia: On the other hand, has small cell size. Often seen in individuals with iron deficiency (most common anemia in the U.S), thalassemia minor and major (genetic mutation), Rheumatoid arthritis., sideroblastic anemia
Signs and symptoms: Patients will present with tiredness/fatigue, tachycardia, shortness of breath, dry, easily bruised skin, pale skin, and dizziness.
Lab investigations: Complete blood count (CBC), Ferritin level, Mean corpuscular volume (MCV).There will be anisocytosis, poikilocytosis, and hypochromia. presents of anisocytosis, poikilocytosis, and hypochromia will be indicated in iron deficiency.
Treatment regimen: Diet modification with iron rich foods like dark leafy vegetables, legumes Ferrous sulfate or ferrous gluconate (which has less elemental iron than ferrous sulfate), thus a greater dosage is required to correct a deficiency. (Dunphy et al, 2023). In a situation of GI malabsorption of iron, parental iron is given. However, if hematocrit is approximately below 30%, RBC IV infusion is indicated. Also , for sideroblastic anemia, vitamin B6 supplement may be added.
Macrocytic Anemia: (aka Pernicious Anemia), usually are related to Folic acid or Vitamin B12 deficiency. Malabsorption, Autoimmune condition. Alcoholics and antimetabolite drugs such as methotrexate are some of the risk factors of macrocytic anemia. DNA mutation and RBC structural change have been implicated.
Signs and symptoms: Confusion and poor concentration, decrease weight or appetite, diarrhea, fatigue, shortness of breath, brittle nails and tachycardia.
Labs investigations: CBC with elevated MCV, Folate and Vitamin B12 level, reticulocyte count, homocysteine levels, hepatic panel, and TSH, T3/T4 (Fedorowicz, 2023).
Treatment; Replacement of folate or Vitamin B12, Treating underlying conditions like malabsorption. (Dunphy et al, 2023)
Sickle cell Anemia: An inherited autosomal recessive disorder, due to gene mutation with cells shaped in a sickled form. This sickle-shaped cell hinders the ability of the cell to perform its function of carrying oxygen to the body tissues.
Symptoms: Patient presents with severe pain during the “crisis” episode.
Lab/diagnostic test: CBC with reticulocyte count, sickle-shaped cells on Peripheral blood smear. Hemoglobin S, Hereditary elliptocytosis and poikilocytosis, Glucose-6-phosphate dehydrogenase (G6PD) (Fedorowicz, 2023)
Treatment; Fluid hydration, Vitamin B and C supplements, Folic acid, Pain management and oxygen supplementation, with the main focus on avoiding acidosis and preventing injury to vital organs. Hydroxyurea for hemoglobin F increase, and transfusion if necessary. (Dunphy et al, 2023)
Evidence-based diagnosis and treatment: Is determined by the type of Anemia involved, with the main aim of identifying the etiology, managing it to enhance symptomatic relief, and improve the quality of life. (Dunphy et al, 2023)
Reference
Dunphy, J.E., Winland-Brown, J.E., Porter, B.O., and Thomas, D.J. (2023). Primary care: The art and science of Advanced Practice Nursing and Interprofessional Approach (6th ed) F.A. Davis
Fedorowicz, Z. (2023, January 26). Anemia in Adults. Dynamed.
https://www.dynamed.com/approach-to/anemia-in-adults-approach-to-the-patient#TOPIC_SW2_RXZ_43B
What is Anemia?. (www.nhlbi.nih.gov/health/anemia) (Updated March 24, 2022)
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