AN EMIA I N H IV

ANEMIA
• ANEMIA IS A CONDITION IN WHICH THE
NUMBER OF RED BLOOD CELLS (RBCs) OR
THE AMOUNT OF HEMOGLOBIN IS
DECREASED IN THE BLOOD.

• RED BLOOD CELLS AND HEMOGLOBIN ARE

RESPONSIBLE FOR CARRYING OXYGEN TO
VITAL ORGANS THROUGHOUT THE BODY.

• ANEMIA IS ONE OF THE MOST COMMON

BLOOD ABNORMALITIES SEEN IN PEOPLE
 INCIDENCE
IT HAS BEEN ESTIMATED THAT UP TO
95% OF PEOPLE INFECTED WITH HIV
WILL EXPERIENCE ANEMIA AT SOME
POINT.

THE INCIDENCE OF ANEMIA RANGES

FROM 10% IN PEOPLE WHO HAVE NO
SYMPTOMS TO 92% IN INDIVIDUALS
WITH ADVANCED AIDS.
 CAUSES FOR ANEMIA IN HIV
NORMAL PROGRESSION OF THE DISEASE. THE
VIRUS CAN INFECT PARTS OF THE BONE MARROW
RESPONSIBLE FOR THE PRODUCTION OF RBCs.
DEFICIENCY OF ERYTHROPOEITIN.
AUTOIMMUNE DESTRUCTION OF BLOOD CELLS
OPPORTUNISTIC INFECTION SUCH AS
MYCOBACTERIAL AND FUNGAL DISEASES.
CANCERS OF BONE MARROW SUCH AS NON-
HODGKINS LYMPHOMA.
NUTRITIONAL DEFICIENCIES.
BLEEDING.
• DRUGS USED IN THE TREATMENT OF
HIV / AIDS

Zidovudine
Amphotericin
Interferon
Dapsone & Pyrimethamine
Septron
Chemotherapy drugs and
Radiation used to treat HIV related
cancers.
 RISK FACTORS FOR
DEVELOPING ANEMIA IN HIV
LOWER CD4 CELL COUNTS.

HIGHER VIRAL LOAD.

TAKING ZIDOVUDINE.

BEING A WOMAN.
WHY ANEMIA IS IMPORTANT IN
HIV?
DECREASED SURVIVAL RATE

POOR QUALITY OF LIFE

HIGH RISK FOR DEVELOPING HEART

COMPLICATIONS

DISEASE PROGRESSION IS 5 TIMES

MORE IN PATIENTS WITH ANEMIA

REDUCED ADHERENCE TO
 SIGNS & SYMPTOMS
FATIGUE & LETHARGY
GIDDINESS & HEADACHE
ANOREXIA
COLDNESS OF HANDS AND FEET
DYSPNEA (EXERTIONAL / AT REST)
TACHYCARDIA
GLOSSITIS & ANGULAR STOMATITIS
IRRITABILITY & DEPRESSION
PALLOR
 MEDICAL MANAGEMENT
IDENTIFICATION AND TREATMENT OF
THE CAUSE.

BLOOD TRANSFUSION.

ERYTHROPOEITIN.

VITAMIN & IRON SUPPLEMENTS.

DIETARY SUPPLEMENTS.
 NURSING MANAGEMENT
IMPORTANT NURSING DIAGNOSES
Activity intolerance related to
imbalance between oxygen supply and
demand.
Imbalanced nutrition less than body
requirements related to inadequate
nutritional intake / disease progression /
side effects of the drugs.
Ineffective management of therapeutic
regimen related to lack of knowledge
NURSING DIAGNOSIS: Activity intolerance related to imbalance
between oxygen supply and demand.
SUBJECTIVE DATA: Patient will complain of fatigue, tiredness,
loss of interest, shortness of breath, palpitations, anorexia.
OBJECTIVE DATA: Reduced activity of the patient, apathy,
tachycardia, reduced Hb% level, pale complexion and lips.
GOAL: 1. Participation in normal activities of daily living without
any abnormal increase in pulse and respiration.
2. Reporting of less weakness and fatigue.
INTERVENTIONS RATIONALE
Monitor Cardio respiratory To evaluate activity intolerance
response to activity
Limit patient’s activity and Reduces undue physical
assist with regular physical exertion
activities.
Encourage alternate rest and Provides activity without tiring
activity periods the patient
Plan activity for periods when Reduces the fatigue, tiredness
patient has the most energy and reduces oxygen demand.
and educate on energy saving
techniques.
Provision of oxygen Provides supplementary
supplementation according to oxygen.
NURSING DIAGNOSIS: Imbalanced nutrition less than body
requirements related to inadequate nutritional intake / disease
progression / side effects
SUBJECTIVE DATA: Patientof the
will drugs. of nausea, vomiting,
complain
anorexia.
OBJECTIVE DATA: Patient doesn’t eat food, weight loss,
Decreased Hb% & Hct
GOAL: 1. Maintains levels.
dietary intake that provides minimum daily
requirements of nutrition.
2. Maintains Normal blood Hemoglobin
INTERVENTIONS and Hematocrit
RATIONALE
values.
Plan with dietician the number To meet the dietary
of calories and type of nutrients requirements of the patient and
needed.
Encourage increased intake of to
To plan intervention.
provided nutrients needed
protein, iron and vitamin-c for the production of
resources.
Encourage small frequent feeds hemoglobin.
To increase the intake of the
and to add flavor such as salt, patient.
sugar or the
Educate lemon.
patient about Helps to evaluate nutritional
maintaining the food diary and intake.
monitor the recorded intake for
nutritional contents.
Provide health education Helps the patient to identify
regarding easily available foods good nutritious food and eat.
rich in nutrition.
Provide supplementary Provides supplementation and
medications as prescribed by helps to improve the nutritional
NURSING DIAGNOSIS: Ineffective management of therapeutic
regimen related to lack of knowledge about medications.
SUBJECTIVE DATA: Patient will say that he stopped medications
because his condition has worsened after taking medications.
OBJECTIVE DATA: Patient will have excess medications at bed
side
GOAL:without consuming.
Verbalizes the knowledge necessary for the management
of medication regimen
INTERVENTIONS RATIONALE
Identify the patient knowledge Helps to plan the intervention.
regarding the medication
regime.
Instruct the patient on the Helps the patient to improve
purpose and action of each their knowledge about the
medication.
Instruct the patient on possible medications.
Helps the patient to identify
adverse reactions of the drugs the serious complications of the
and to approach health care drug therapy and will approach
professionals if it occurs.
Educate the patient about the the healththe
Improves care professionals.
medication
ill effects of stopping the drugs compliance.
without the physician’s advice.
Provide counseling and For future reference of the
handout in their language on patient.
discharge regarding drug
 SUMMARY

Apart from Nutritional Deficiencies,

Anemia in HIV is caused by various factors
such as Bone marrow depression,
Deficiency of Erythropoietin, autoimmune
disorder, opportunistic infections and
even the drugs which are used to treat
HIV. So it must be treated and proper
nursing care to be given to the patient so
as to not only improve their quality of life
but also to increase their survival rate.