Low Hemoglobin Nursing Diagnosis & Care Plan

Hemoglobin is a protein in the blood that carries oxygen and carbon dioxide to and from the tissues and organs back to the lungs. The body makes hemoglobin through iron, a natural component of red blood cells (RBC). 

Normal hemoglobin levels are 14 -18 g/dL for adult males and 12 – 16 g/dL for adult females. What is considered “low” will vary between facilities and patients.

Low hemoglobin is often caused by low iron levels in the blood or iron deficiency anemia and may lead to severe health conditions, including heart problems. Other causes of low hemoglobin include:

• Diet low in iron
• Recent gastrointestinal surgery
• Heavy menstrual bleeding
• Gastrointestinal bleeding
• Recent blood donation 
• Pregnancy
• Growth spurts in children
• Certain medical conditions like anemia, sickle cell disease, cancer, cirrhosis, chronic kidney disease, and leukemia

Signs and symptoms of low hemoglobin include:

• Weakness
• Fatigue
• Shortness of breath
• Cyanosis
• Pale skin and gums
• Fast and irregular heartbeat

A complete blood count, including red blood cell count and hemoglobin level, can help confirm low hemoglobin and other blood cell abnormalities.  

Nursing Process

The treatment and management of low hemoglobin include diagnosing and treating the underlying cause. Nursing care includes patient education of the cause, prognosis, and complications of the condition, provision of iron supplementation, adherence to an iron-rich diet, monitoring of symptoms, and lifestyle modifications.

Fatigue

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.

Nursing Diagnosis: Fatigue

• Disease process
• Diminished oxygen-carrying capacity of the blood

As evidenced by:

• Difficulty maintaining usual physical activity 
• Difficulty maintaining usual routines
• Expresses a lack of energy
• Expresses weakness 
• Expresses tiredness 
• Insufficient physical endurance
• Inadequate role performance
• Lethargy 

Expected outcomes:

• Patient will demonstrate interventions to reduce fatigue.  
• Patient will identify factors that aggravate feelings of tiredness and weakness.

Assessment:

1. Assess the severity, frequency, and activities that aggravate fatigue.
Fatigue can limit the patient’s ability to perform role responsibilities or perform in their career or complete schoolwork. Assess if there are certain times or other factors that contribute to fatigue.

2. Assess laboratory values.
Monitoring complete blood counts helps determine the progression of the patient’s condition and the effectiveness of interventions.

Interventions:

1. Set realistic goals.
Help the patient plan tasks and set limits for each day. Have them prioritize and complete the most important tasks when energy reserves are highest.

2. Administer medications as needed.
Patients with low hemoglobin may be given erythropoietin-stimulating drugs to help generate more red blood cells.

3. Provide supplemental oxygen.
If cells and tissues are not receiving adequate oxygenation, supplemental oxygen may be required.

4. Eat iron-rich foods.
If the patient has iron-deficiency anemia, they may need to increase iron in the diet by eating red or organ meats, fish, green leafy vegetables, beans, and nuts.

Activity Intolerance

Low hemoglobin levels can be detrimental to a patient’s performance, mobility, and overall health. Low hemoglobin limits the body’s capacity to transport oxygen, causing fatigue and reducing work or exercise capacity.

Nursing Diagnosis: Activity Intolerance

• Disease process
• Low hemoglobin
• Imbalance between oxygen supply/demand
• Fatigue

As evidenced by:

• Exertional dyspnea
• Expresses fatigue 
• Generalized weakness
• Tachycardia
• Tachypnea

Expected outcomes:

• Patient will report the ability to perform activities of daily living without dyspnea or extreme fatigue.  
• Patient will identify interventions to reduce activity intolerance.

Assessment:

1. Assess the degree of activity intolerance.
Assess the severity of activity intolerance. Can the patient walk more than 50 feet? Climb stairs? Are they fatigued at rest? What activities can they no longer perform?

2. Assess the patient’s oxygen saturation.
Activity intolerance and fatigue may be precipitated by decreased oxygen saturation.

3. Assess for signs of activity intolerance.
Signs of activity intolerance, fatigue, and reduced tissue oxygenation include dyspnea on exertion, dizziness, headaches, palpitations, and pallor.

Interventions:

1. Encourage adequate rest periods.
Activity intolerance may be aggravated by fatigue. Adequate rest periods can reduce fatigue and promote activity tolerance.

2. Encourage the patient to ask for help.
The patient may be reluctant to ask for help with self-care or household responsibilities. Explain that this increases their risk of injury and will further worsen activity intolerance and fatigue. Help them identify tasks that can be delegated.

3. Instruct on activities that require minimal exertion.
Slowing down may be difficult if the patient is accustomed to an active lifestyle. Instruct on low-impact ways the client can stay active such as short walks, stretching, or light yoga.

4. Administer medications as indicated.
Medications like iron supplements and erythropoietin replacement can help improve low hemoglobin and iron, reducing symptoms of fatigue and activity intolerance.

Risk for Bleeding

Patients may experience low hemoglobin as a result of bleeding or coagulation abnormalities.

Nursing Diagnosis: Risk for Bleeding

• Low hemoglobin 
• Trauma
• Surgical intervention
• Sickle cell anemia
• Internal bleeding

As evidenced by:

A risk diagnosis is not evidenced by signs and symptoms, as the problem has not occurred yet, and nursing interventions are directed at the prevention of signs and symptoms.

Expected outcomes:

• Patient will discuss and demonstrate interventions to prevent bleeding. 
• Patient will demonstrate hemoglobin, hematocrit, and coagulation values within acceptable limits.

Assessment:

1. Assess for any signs of bleeding.
Bruising or hematomas, blood in the stool or urine, pallor, dizziness, tachycardia, or hypotension are signs of bleeding.

2. Assess and monitor laboratory values.
Low hemoglobin, hematocrit, platelet count, and alterations in PT/aPTT levels can signal issues with bleeding.

Interventions:

1. Educate the patient about bleeding precautions.
Bleeding precautions like using a soft toothbrush and the use of an electric shaver instead of a razor can decrease the risk of spontaneous bleeding.

2. Apply pressure over the site as appropriate when bleeding occurs.
Bleeding can be stopped by applying pressure to allow blood to clot.

3. Administer blood products as indicated.
A blood transfusion may be indicated for patients with low hemoglobin and bleeding.

4. Locate the cause and stop the bleeding.
Early identification and intervention through imaging, procedures, or surgery can prevent internal bleeding and worsening complications.

References

1. ACCN Essentials of Critical Care Nursing. 3rd Edition. Suzanne M. Burns, MSN, RRT, ACNP, CCRN, FAAN, FCCM, FAANP. 2014. McGraw Hill Education.
2. Anemia. WebMD. Reviewed: November 02, 2022. From: https://www.webmd.com/a-to-z-guides/understanding-anemia-basics
3. Low Hemoglobin. Cleveland Clinic. Reviewed: May 4, 2022. From: https://my.clevelandclinic.org/health/symptoms/17705-low-hemoglobin
4. Low hemoglobin count. Mayo Clinic. Reviewed: May 245, 2022. From: https://www.mayoclinic.org/symptoms/low-hemoglobin/basics/causes/sym-20050760
5. Low Hemoglobin: Everything You Need to Know. Very Well Health. Published: March 16, 2022. From: https://www.verywellhealth.com/low-hemoglobin-5217077
6. Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care. 9th Edition. Donna D. Ignatavicius, MS, RN, CNE, ANEF. 2018. Elsevier, Inc.

Discovering the Science: Evaluating Blood Test Results

Contents

• 1 Evaluate the Attached Blood Test Results
  • 1.1 Why Evaluate Blood Test Results
  • 1.2 What Data Can Be Obtained from a Blood Test
  • 1.3 Evaluating a Blood Test blood
  • 1.4 Deciphering the leukocyte formula
  • 1.5 Assessment of the level of erythrocytes
  • 1.6 Assessment of hemoglobin and hematocrit
  • 1.7 Assessment of platelets
  • 1.8 White blood cell count
  • 1.9 Coagulation system score
  • 1.10 Blood chemistry score
  • 1.11 Related videos:

to get information about the state of your body. In a blood test, levels of various indicators are measured, such as hemoglobin, white blood cells, platelets, and others. By evaluating these results, you can determine the presence or absence of abnormalities and get your doctor’s advice on how to proceed.

Blood testing is one of the most popular and important research methods in medicine. It allows you to get information about the state of the body, identify possible diseases, evaluate the effectiveness of treatment, and much more. However, in order to correctly interpret the results of the analysis, it is necessary to be able to evaluate them.

The evaluation of blood test results is based on the analysis of indicators that indicate the normal or pathological state of the body. These can be indicators such as the level of glucose, cholesterol, hemoglobin, leukocytes and others. Their values ​​are compared with reference values, which are established on the basis of statistical data.

In addition, evaluation of blood test results includes analysis of abnormalities and changes in parameters. For example, an elevated glucose level may indicate diabetes, and an elevated white blood cell count may indicate an inflammatory process in the body. It is also important to consider the context and symptoms the patient is presenting with. This helps to more accurately interpret the results of the analysis and make the correct diagnostic conclusion.

Why evaluate blood test results

Evaluation of blood test results is one of the key steps in the diagnosis of various diseases and conditions of the body. A blood test provides information about the condition of the blood and allows you to identify abnormalities that may indicate the presence of diseases. Thus, the evaluation of the results of the blood test helps the doctor to make the correct diagnosis and prescribe effective treatment.

Blood test evaluation includes analysis of indicators such as hemoglobin levels, red blood cell, white blood cell and platelet counts, and levels of various substances such as glucose, cholesterol and electrolytes. Based on these indicators, the doctor can determine the presence of anemia, infections, inflammatory processes, disorders of the body’s organs and systems, and other diseases.

Evaluation of the results of the blood test also allows you to monitor the effectiveness of the treatment. Conducting a second blood test some time after the start of treatment allows you to assess what changes have occurred in the patient’s body and how successful the treatment is.

In addition, evaluation of blood test results may be useful for preventive purposes. Regular blood tests allow you to monitor your health and timely detect the initial stages of various diseases, even if the patient does not experience any symptoms. This allows you to start treatment at an early stage, when the results can be more effective.

What data can be obtained from a blood test

A blood test is the main diagnostic test that provides a lot of valuable information about the state of the human body. This analysis provides data on the number of different cells in the blood, as well as the content of various chemicals.

One of the main indicators of a blood test is the total number of erythrocytes – red blood cells. This allows you to determine the level of hemoglobin – an important component that is responsible for the supply of oxygen to organs and tissues. Also, a blood test can reveal the presence of anemia or other disorders in the hematopoietic system.

In addition, a blood test allows you to determine the level of leukocytes – cells responsible for immunity and protective functions of the body. A high white blood cell count may indicate inflammation or infection, while a low white blood cell count may indicate an immune system disorder.

A blood test can also provide information on the number of platelets, the cells responsible for blood clotting. This helps to identify coagulation disorders and determine the risk of thrombosis.

In addition to these data, a blood test may also include measurements of glucose, cholesterol, protein, and other substances that may indicate the presence of a disease or disorder in the body.

Thus, a blood test provides a doctor with a lot of useful information for diagnosing and monitoring the patient’s condition. The results of this study help to determine the presence of diseases, track the dynamics and effectiveness of treatment, and make the necessary medical decisions.

Complete blood count

Complete blood count is one of the main tests that is carried out to assess the state of the body. It gives information about the number of different blood cells, their shape, size and function.

The evaluation of the complete blood count includes several basic indicators. The first and most important is the number of erythrocytes – red blood cells that are responsible for transporting oxygen to organs and tissues. The normal number of red blood cells varies depending on the sex and age of the person.

In addition, important indicators are the level of hemoglobin and hematocrit. Hemoglobin is a protein in red blood cells that binds oxygen and delivers it to organs and tissues. Hematocrit is the ratio of the volume of red blood cells to the total volume of blood. They reflect the blood’s ability to carry oxygen and may be an indicator of anemia or other diseases.

The CBC score also includes white blood cells, white blood cells that play a role in the body’s immune defenses. An increased number of white blood cells may indicate the presence of an inflammatory process, infection, or other pathological conditions. Evaluation of the proportion of different types of leukocytes – neutrophils, lymphocytes, monocytes and others – can also provide additional information about the state of the immune system.

Important indicators of the general blood test are platelets – cells responsible for blood clotting and wound healing. A low platelet count can indicate a clotting disorder and be an indicator of bleeding or blood disorders.

All these indicators, as well as others included in the complete blood count, are important for assessing health and identifying possible diseases. The results of the analysis can be used by doctors to make a diagnosis, monitor the patient’s condition and select the optimal treatment.

Leukocyte formula interpretation

The leukocyte formula is the result of a blood test that reflects the percentage of different types of leukocytes in the total leukocyte population.

Leukocytes are white blood cells that perform an important protective function in the body. They are distinguished by the shape of the nucleus and the type of granules in the cytoplasm. The following types of leukocytes are usually indicated in the leukocyte formula:

• Neutrophils are the largest class of leukocytes that have a segmented nucleus. They play an important role in fighting infections and inflammation.
• Lymphocytes are cells with a round nucleus that perform the function of an immune response. They are responsible for the production of antibodies and are involved in the formation of immunity.
• Monocytes are large cells with a large nucleus that effectively destroy pathogenic microorganisms. They also play an important role in the formation of immunity.
• Eosinophils are cells with large granules in the cytoplasm that are involved in allergic reactions and the fight against parasitic infections.
• Basophils – cells with large granules in the cytoplasm, which are involved in the development of allergic reactions and inflammation.

The analysis of the leukocyte formula allows you to assess the state of the immune system and identify abnormalities associated with infectious diseases, allergies or other pathologies. The results obtained help the doctor determine the diagnosis and prescribe the appropriate treatment.

Red blood cell count

Red blood cells are red blood cells that play an important role in the human body. They are responsible for transporting oxygen from the lungs to tissues and organs, as well as removing carbon dioxide from the body. The level of red blood cells can be assessed using a blood test, which includes measuring parameters such as the number of red blood cells per unit volume of blood.

The normal level of red blood cells in the blood depends on sex, age and other factors. Usually, in men it is higher than in women, and in newborns it is lower than in adults. A low level of red blood cells may indicate the presence of anemia or other blood disorders, while an elevated level may indicate dehydration, hypoxia, or other disturbances in the functioning of the body.

Before having a blood test to evaluate the level of red blood cells, it is important to follow certain recommendations, such as not eating before the test, avoiding exercise and stress, and following the doctor’s instructions. The results of the analysis should be interpreted in combination with other indicators in order to get a more complete picture of the state of the body.

Hemoglobin and hematocrit assessment

Hemoglobin and hematocrit are two important indicators of a blood test that reflect the state of the body’s hematopoietic system. Hemoglobin is the main component of erythrocytes – red blood cells, its level allows you to assess the ability of blood to carry oxygen from the lungs to tissues. Hematocrit is the ratio of the volume of red blood cells to the total volume of blood and is an indicator of its viscosity.

Hemoglobin is usually measured in grams per deciliter of blood (g/dl) and ranges from 13.5 to 17.5 g/dl for men and 12.0 to 15.5 g/dl for women. A change in hemoglobin levels may indicate various conditions of the body, such as anemia or polycythemia.

Hematocrit is measured as a percentage and the norm for men is from 38 to 50%, and for women – from 34 to 44%. A low hematocrit may be associated with blood loss or anemia, while an elevated level may be associated with dehydration, hemoconcentration, or polycythemia.

A blood test is commonly used to measure hemoglobin and hematocrit, which involves drawing blood from a vein and having it measured in a laboratory. These indicators help doctors assess the condition of the blood and identify the presence of any disorders in the body.

Platelet evaluation

Platelets are important cells responsible for stopping bleeding and forming blood clots. They are synthesized in the bone marrow and circulate in the blood in an inactive state until vascular damage occurs.

The blood test evaluates platelet-related parameters such as the total number of platelets per unit volume of blood and their shape and size. This allows you to determine the presence or absence of problems with platelets.

The normal number of platelets in an adult is 150-400 thousand per cubic millimeter of blood. If the platelet count is low (thrombocytopenia), it may be due to various causes, such as immune system disorders, bone marrow disorders, or loss of platelets due to bleeding.

Conversely, an increased number of platelets (thrombocytosis) may be associated with inflammation, infection, tumors, bone marrow disease, or after removal of the spleen.

White blood cell count

White blood cells are cells that perform an important function in our body, namely, they provide protection against infections and other harmful influences. When analyzing blood, you can evaluate the number and condition of leukocytes, which is an important indicator of the health of the body.

The normal level of leukocytes in the blood ranges from 4000 to 11000 per 1 µl. With a low level of white blood cells (leukopenia), there is an increased susceptibility to infections and a decrease in the protective functions of the body. With an increased level of leukocytes (leukocytosis), it may be evidence of various inflammatory processes, infections, allergic reactions, or even malignant tumors.

For a more accurate assessment of the level of leukocytes, a differential leukocyte count is usually used – this is an analysis that allows you to determine the percentage of different types of leukocytes in the blood. For example, an elevated neutrophil count may indicate bacterial inflammation, and an elevated lymphocyte count may indicate a viral infection. All this allows the doctor to more accurately determine the cause of the change in the level of leukocytes and prescribe the necessary treatment.

Evaluation of the coagulation system

The blood coagulation system is a complex mechanism responsible for stopping bleeding and the formation of blood clots. Evaluation of the coagulation system is an important part of the blood test. It allows you to evaluate the state of functioning of all components of the coagulation system.

One of the key indicators of the coagulation system is the blood clotting time or prothrombin time. This indicator reflects the period of time during which thrombin is formed as a result of activation of clotting factors. Abnormalities may indicate the presence of disorders in the blood coagulation system, such as a deficiency of coagulation factors or the presence of antibodies to them.

Another important indicator is activated partial thrombin time (APTT). It allows you to evaluate the work of the internal and general pathways of blood coagulation. Abnormalities may indicate a deficiency of clotting factors or the presence of impaired platelet function.

The evaluation of the coagulation system also includes the number of platelets in the blood. Platelets are key participants in the blood coagulation process, their deficiency can lead to bleeding, and their excess to the formation of blood clots and thromboembolism.

Depending on the results obtained, conclusions can be drawn about the presence of disorders in the blood coagulation system. For a more detailed assessment of the patient’s condition, additional indicators can be used, such as activation of fibrinolysis and fibrinogen concentration.

Evaluation of a biochemical blood test

Biochemical blood test is one of the most informative methods for diagnosing diseases of the body. It allows you to assess the functional state of various organs and systems, to determine the presence or absence of pathological processes.

As a result of a biochemical blood test, various indicators are determined that reflect the state of the body. For example, the glucose level allows you to evaluate carbohydrate metabolism and detect the presence of diabetes. The concentration of protein in the blood reflects the state of the liver and kidneys. The level of cholesterol allows you to assess the state of the cardiovascular system. Creatinine and urea reflect kidney function. The leukocyte formula helps to identify the presence of inflammatory processes in the body.

To evaluate the result of a biochemical blood test, it is necessary to take into account the normal values ​​​​of indicators depending on the age and sex of the patient. If the level of the indicator is outside the normal range, this may indicate the presence of diseases or disorders in the body.

It is important to note that the results of a biochemical blood test are not exclusive diagnostic criteria. They should be considered in conjunction with other data – the clinical manifestations of the disease, anamnesis, the results of other laboratory and instrumental studies.

All of the above leads to the conclusion that the evaluation of a biochemical blood test is an important part of the complex diagnosis of diseases and helps the doctor decide what treatment and precautions should be taken for the patient.