Anaemia is a pathological condition characterised by a reduction in the oxygen-carrying capacity of the blood, resulting from a decrease in the concentration of circulating haemoglobin, red blood cell mass, or packed cell volume below normal reference ranges for age and sex.
At the cellular level, inadequate tissue oxygenation triggers compensatory physiological mechanisms. The sympathetic nervous system increases heart rate and stroke volume to enhance cardiac output. Simultaneously, the kidneys increase erythropoietin production to stimulate bone marrow erythropoiesis. When these compensatory mechanisms fail to meet systemic oxygen demands, clinical symptoms of tissue hypoxia emerge.
Classifying anaemia helps identify the root cause, usually categorizing them by red blood cell size and haemoglobin content using indices like Mean Corpuscular Volume.
Clinical features of anaemia vary depending on the severity and the speed of onset. Patients often exhibit generalized weakness, chronic fatigue, and exercise intolerance as early signs.
Pallor of the skin, nail beds, and conjunctivae reflects reduced blood flow and lower haemoglobin levels in superficial tissues. Cardiovascular signs include tachycardia, palpitations, and systolic flow murmurs as the heart pumps faster to compensate for low oxygen levels. Severe cases can present with shortness of breath on exertion, dizziness, and koilonychia in chronic iron deficiency.
Laboratory testing confirms the diagnosis of anaemia and guides targeted intervention.
Medical management focuses on correcting the underlying cause, restoring adequate haemoglobin levels, and replenishing nutritional stores.
For iron deficiency anaemia, oral iron supplements like ferrous sulfate are standard, though parenteral iron may be used if absorption is poor. Megaloblastic anaemia requires vitamin B12 injections or oral folic acid replacement. In severe or acute symptomatic anaemia, packed red blood cell transfusions are administered cautiously to avoid circulatory overload. Addressing chronic infections or hookworm infestations is equally vital in endemic regions to stop ongoing blood loss.
Nursing care centers on managing symptoms, promoting safety, and ensuring therapeutic adherence. Nurses monitor vital signs closely for signs of hemodynamic instability or worsening respiratory effort.
Activity intolerance is managed by scheduling nursing activities around rest periods to conserve patient energy. For patients taking oral iron, nurses educate them on expected side effects like dark-colored stools and advise taking supplements with vitamin C to enhance absorption while avoiding milk or antacids that inhibit uptake. Safety precautions are instituted for patients experiencing dizziness or orthostatic hypotension.
Untreated chronic anaemia can lead to severe complications, most notably high-output cardiac failure due to the heart constantly overworking to compensate for hypoxia. Pregnant women with severe anaemia face higher risks of postpartum haemorrhage, low birth weight, and increased maternal mortality.
Patient education must emphasize dietary modifications, including the consumption of local iron-rich foods such as dark green leafy vegetables, beans, and lean meats. Adherence to prescribed medication schedules and completion of the full course of treatment are reinforced to prevent relapse.