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LESSON PLAN ON IRON DEFICIENCY

ANEMIA
NAME OF THE STUDENT TEACHER : Ms. A. ARIVUKKARASI, II YEAR M.Sc., NURSING

TOPIC : Obestrical and Gynaecological Nursing

GROUP : Antenatal mother

SIZE OF GROUP : 60

VENUE : Sacred Heart Multispeciality Hospital

DURATION : 30 MINUTES

MEDIUM OF INSTRUCTION : TAMIL

METHOD OF TEACHING : VIDEO ASSISTED TEACHING PROGRAMME


GENERAL OBJECTIVES:

At the end of this session iron deficiency anemia mother will be able to gain knowledge regarding iron deficiency
anemia among antenatal mothers attended in outpatient department.

SPECIFIC OBJECTIVES:

At the end of this session the patient will able to know about

 introduction of iron deficiency anemia


 define the iron deficiency anemia
 the incidence of iron deficiency anemia
 the types of iron deficiency anemia
 the etiological factors of iron deficiency anemia
 the risk factors of iron deficiency anemia
 enumerate the pathophysiology of iron deficiency anemia
 list out clinical manifestation of iron deficiency anemia
 explain enumerate the detail about diagnostic of iron deficiency anemia
 explain and details about iron deficiency anemia
 explain the prevention of iron deficiency anemia
 list out the complication of iron deficiency anemia.
INTRODUCTION

Women go through a variety of physiological changes during pregnancy changes in the blood
circulatory system are particularly notable, permitting normal fatal growth. Even in normal pregnant
women the hemoglobin concentration decreases with dilution according to the increase in the volume of
circulating blood. Since iron and folic acid in amounts necessary to the fetus are pregnant women is 14
percent in developed and 51 percent in developing countries and 65- 75 percent in India.

Commonest medical disorder in pregnancy one of estimated 160 million deliveries occurring
annually in the world approx 6,00,000 women dies from the complication of pregnancy & child birth
(WHO 1996)
LEARNI
SPECIFIC TEACHING NG EVALUATI
S.No Time CONTENT AV-AIDS
OBJECTIVES ACTIVITY ACTIVI ON
TY
1 2mts Defined the iron DEFINITION With the Lecture listening What is meant
deficiency help of method by iron
Iron deficiency anemia is
anemia multimedia deficiency
defined as a red blood
communic
cells cannot carry
ation
enough oxygen to body
tissues.
2 5mts List out the Etiology of iron With the Lecture listening
etiological help of method
deficiency anemia.
factor of iron multimedia
Common causes
deficiency communic
anemia  Inadequate iron ation
intake due to poor
diet or restrictive
diets.
 Inflammatory bowel
diseases.
 Inability to absorb
iron.

3 5mts Causes of Female: With the


help of
 In women of during
multimedia
pregnancy in mainly
communic
affected antenatal
ation
period of child
bearing age and most
cause of menstruation
or pregnancy.
 Endometriosis
 Gastro intestinal
problem during
cancer,
 Stomach ulcer
 Non steroidal intake
 Chronic kidney
disease.

Causes of anemia in With the Lecture listening


help of method
pregnancy
multimedia
 Nutritional – iron
communic
folate and vitamin b12
ation
deficiencies acute or
chronic blood loss
(gastrointestinal
bleeding, heavy
periods)
 Infection - malaria
 Hemolytic anemia,
drugs Congential What are the
 Nutritional iron etiological
deficiency anemia factors for
(IDA) is the iron
commonest (90% deficiency
cause of anemia in anemia?
pregnancy).
4 5mts The risk factors RISK FACTORS With the Lecture Listening
of anemia in help of method
FOR ANEMIA IN
pregnancy multimedia
PREGNANCY communic
All pregnant women are at ation
risk for becoming anemic
that’s because they need
more iron and folic acid than
usual. But the risk is higher
if you are pregnant with
multiples (more than one
child)
(vomit a lot because of
morning sickness)
During ante natal period
untreated IDA can increase
your risk of having a preterm
or low birth weight baby.
Post preterm depression and
Hyper tension
 Placenta previa.
 A baby with anemia List out the

 A child with risk factors of

developmental delays iron

 Premature rupture of deficiency

membrane. anemia?

4 5mts Types of anemia TYPES OF With the listening


help of
ANEMIA
multimedia
 Iron deficiency anemia
communic
 Vitamin B12
ation
deficiency anemia
 A plasmic anemia
 Anemia associated
with bone marrow
disease.
 Hemolytic anemia
 Sick cell anemia.
 In iron deficiency
anemia the blood
cannot carry enough
oxygen to tissues
throughout the body.
 Iron deficiency is the
most common cause
of anemia in
pregnancy.
Vitamin B12 deficiency
 The body needs Vit
B12 to form healthy
red blood cells.
When a pregnant
women doesn’t get
enough vitamin B12
from her diet, her
body can’t produce
enough healthy red
blood cells.
5 3mts Enumerate the PATHOPHYSIOLOGY With the Lecture Listening Enumerate the
pathophysiology OF IRON DEFICIENCY help of method pathophysiolo
of iron ANEMIA: multimedia gy of iron
deficiency Due to etiological anemia communic deficiency
anemia. ation anemia.
Decrease in RBCS, HB or HCC
leval

Diminished o2 – carrying
capacity
Hypoxia and hyponia induced
effects of organ function

Signs and symptoms of anemia


6 2mts Incidence of INCIDENCE OF ANEMIA: With the Lecture Listening
anemia  Anemia in help of Method
pregnancy is present multimedia
in very high communic
percentage of ation
pregnant women in
India.
 Exact data is not
available about the
prevalence of
nutritional anemia.
However according
to WHO, the
prevalence of
anemia in pregnancy
south east Asia is What is
around 56%. incidence of
 In India incidence of anemia?
anemia pregnancy
has been noted as
high as 40 – 80%
7 5mts List out clinical CLINICAL Lecture Listening
manifestation MANIFESTATION OF method
iron deficiency IRON DEFIECIENCY
anemia ANEMIA DURING
PREGNANCY:
 Extreme fatigue
 Pale skin Nail lips
 Chest pain fast
heart beat
Or shortness of breath.
 Headache,
dizziness or light
headedness
 Cold hand and feet
 Inflammation or
soreness of your
tongue.
 Brittle nails
 Unusual cravings
for non nutritive
substances, such as
ice diet or starch.
 Poor apetite,
especially in
infants and children
with iron
deficiency anemia.
 Trouble
concentrating a low
body temperature
Irritability due
specifically to a
B12 deficiency. List out the
 Mild dyspnea clinical
during exertion. manifestation
 Severe tachycardia of anemia?
or hypotension.
8 5 mts Enumerate the DIAGNOSTIC EVALUATION With the Lecture Listening
OF IRON DEFICIENCY
details about help of method
ANEMIA IN ANTE NATAL
diagnostic MOTHER:
multimedia
evaluation of  History collection communic
iron deficiency  Physical examination ation
anemia.  Clinical assessment
 Laboratory bio
medical investigation
The three levels not only Lecture
help to determine the method
underlying causes of iron
deficiency anemia as we
discussed earlier but also
how to diagnose anemia.
HISTORY
COLLECTION:
 During pregnancy
many causes, doctors
don’t diagnose anemia
until they run blood Listening
test as part of blood
test as part of routine
test.
 Throughout the details
family history any
signs and symptoms of
pregnancy.

 During pregnancy
period before ask for
mother last menstrual
period is regularly and
any bleeding disorder
before marriage poly
Lecture
menorrhea and
polycystic ovarian method
disease of medical Listening
treatment.
 Recurrent abortion due
to miscarriage of
body.
 Collection of family
hereditary disorders.

PHYSICAL
EXAMINATION OF
DURING PREGNANCY
IN IRON DEFIECIENCY
ANEMIA:

 During pregnancy
examination of
antenatal mother
clinical findings such Enumerate the
as Pallor of
details about
conjunctiva
 Palmar causes have diagnostic
traditionally been used evaluation of
by physician in the
iron
diagnose in anemia.
deficiency
anemia.
9 5M ts PHYSICAL FINDINGS With the Lecture Listening
ASSOCIATED WITH help of method
SPECIFIC ANEMIA:
multimedia
Iron deficiency anemia:
communic
 Cheilosis
ation
 Koilonychia
 Glossitis
Secondary to bleeding:
 Melena
 Haematochezia
 Hematuria
 Haematemesis
Secondary to
malabsortion:
 Dermatitis
herpetiformis
Laboratory investigations:
 Complete blood count
(CBC) erythrocyte
sedimentation rate
(esr), pheripheral
smear study
10 3mts Explain details Management of iron Lecture Listening
about the deficiency anemia in ante method
management of natal mother
iron deficiency  Medical management
anemia  Nursing management
 Medical
management:
WHO recommendation
Universal oral iron
supplementation for pregnant
women (60mg of element
iron and 400 µg of folic acid)
for 6 months in pregnancy
and additional of 3 months
post partum where the
prevalence is more than 40%
10 10mts Side effect of Side effects of anemia on With the Lecture Listening
iron deficiency pregnancy: help of method
anemia Mother (pregnancy): multimedia
Cardiac failure at 30-34 communic
weeks of pregnancy ation
Increased infection
Preterm labour
Preeclampsia
Labour:
Uterine inertia post partum
haemorrage ,cardiac failure
shock.

Puerperiun:
Cardiac failure
Puerperal sepsis
Subinvolution
Failing lactation
Chronic ill health backache.

Fetus & neonate:


Prematurity, IUGR,
increased perinatal death,
Decreased iron stores in
neonate

Side effects of oral iron :


Upper GI track:
Nausea, gastric discomfort
loss of appetide, staining of
teeth.

Lower GI tract:
Constipation,
diarrohea, ,constipation.

Nursing management :
Aims:
To correct iron deficiency.
To restore iron reserve
To correct associated
complication factor.
Choice of theraphy:
Depends on severity of
anemia.
Duration of pregnanacy
Association complicating
factor

General treatment:
Dietary advice
Treatment of associating
complicating factor.

Antenatal care: With the Lecture Listening


More frequent visit help of method
Detect and manage multimedia
complication as heart failure communic
Fetal monitoring for growth ation
and well- being

Health history, and


physical exam:
Both provide important data
about the type of anemia
data about the type of
anemia involved. The extent
and type of symptoms it
produces and the impact of
those symptoms on the
patient life.

Family history: With the Lecture Listening


Assess if the patient family help of method Listening
history is important because multimedia Lecture
certain anemias are inherited. communic method
Nutrirional assessment: ation
Assessing the nutritional With the
status and habits is important help of
because it may include multimedia
deficiency in essential communic
nutrients such as iron, ation
vitamin B12 and folic acid.
Non – pharmacological
treatment:
Iron rich diet:
Good sources of iron
includes:
Meats, beef, pork, lamb,
liver, and other organ meats.
Poultry- chicken , duck,
turkey, liver (especially dark
meat)
Fish – shellfish, including
mussels,
Leafy green of the cabbage
Legumens such as lima
beans and green peas dry
beans Explain in
detail about
the nursing
management
of iron
deficiency
anemia.?

11 5mts Enumerate the Health education of iron With the Lecture Listening
health education deficiency anemia: help of method
and prevention  Assessment of multimedia
of iron nutritional intake and communic
deficiency anemia ation
anemia  Encourage client to eat
food high in iron and
folic acid like green
leafy vegetables, fish
meat poultry eggs and
legumes.
 Encourage to take
foods high in vitamin
C for iron absorption.
 Emphasize diet high in
fiber and fluids to
avoid constipation side
effect of iron
deficiencies.
 Emphasize and also
good hygiene to avoid
urinary track infection.
 Observe and monitor
heamotologic
laboratory results.
 Teach client to watch
out for signs and
prefer labour
 Observe and monitor
fetal well being.
 Allow client to rest as
much as possible and
provide emotional
support.
12 5 mts Prevention of Prevention of iron With the Lecture Listening
iron deficiency deficiency anemia: help of method
anemia  Iron is an essential multimedia
nutrient communic
 Decreased physical ation
activity and work
productivity
 Lowered immunity
 Increased infections
disease risk.
 Iron deficiency in
human has wide
ranging negative
consequences,
including impaired
physical growth,
compromised
cognitive
development, short
attention span and
impaired fat
absorption, increased
bad absorption with all
its negative

13 2 mts List out the Complication of during With the Lecture Listening
complication of pregnancy in iron help of method
during iron deficiency anemia: multimedia
deficiency Mother: communic
anemia Severe iron deficiency ation
anemia has been linked to
premature birth and low birth
weight babies.

Infection :
Pregnancy induced
hypertension
FETUS:
Infra uterine growth
retardation
Intra uterine death
absorption.

Late complication: What are all


Hematological disease the
Paroxyzmal nocturnal complication
hemoglobinuria of iron
Myelodysplasia deficiency
acute mylogenous leukemia anemia?

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