BORA INSTITUTE OF ALLIED HEALTH SCIENCE

LUCKNOW

SUBJECT: NURSING EDUCATION

TOPIC: MICRO TEACHING ON

SIMULATED TEACHING

SUBMITTED TO SUBMITTED BY

Mrs. MONIKA MASIH RANJITA GAUR

NURSING TUTOR M.Sc. NURSING I YEAR

SUBMITTED ON:
 KING GEORGE’S MEDICAL UNIVERSITY, LUCKNOW
KGMU COLLEGE OF NURSING
MODEL EXAMINATION 2021
MEDICAL SURGICAL NURSING II
GNM II YEAR
Duration-3 hours
Max.Marks-75
Q.1 Four option of answer of each question are given, only one option is correct. Choose the
correct answer.
(A) “Rules of nine” helps to identify the severity of...
1. Haemorrhage
2. Burn
3. Growth retardation
4. Physical disability
(B) Leukaemia is…….
1. A cancer of blood vessels
2. A cancer of blood and bone marrow
3. A cancer of stomach
4. An infection
(C) Most common cause of MI
1. Coronary artery disease
2. Liver cirrhosis
3. Renal failure
4. Cerebrovascular accident
(D) Common site of psoriasis includes
1. Palate, nasal septum and knees
2. Knee, nape of neck and elbow
3. Elbow, knee and scalp
4. Scalp, eyebrow and gluteal fold
(E) TNM staging system refers to
1. Type, node and mode
2. Tumor, node and metastasis
3. Type, node and metastasis
4. Tumor, node and mode (1X5=5)
Q.2 Choose TRUE and FALSE in the following statement (1X5=
5)
1. The retina is the nerve layer located at the back of eye. ()
2. Feeling of internal organ by finger pad is called manipulation. ()
3. Extravasation refers to leakage of fluid into the tissues. ()
4. Surgery is a most important aspect of management of burn in first 24 hours. ()
5. Insect responsible for transmitting disease are called transmitter. ()
Q.4Write the short notes on any 4 of the following. (4X5=20)
1. Radiation therapy
2. Tonsillitis
3. Classification and complication of burn
4. Classification and complication of burn
5. AIDS
Q.5Answer any 4 in detail of following: (4X10=40)
(a) Define Glaucoma (2+3+5=10)
(b) Enlist the causes of Glaucoma
(c) Explain medical, surgical and nursing management of Glaucoma
2. (a)Explain classification and causes of Fracture
(b)Explain management of Fracture
3. (a)Define Thalassemia (2+4+4=10)
(b) Pathophysiology of Thalassemia.
(c) Medical and nursing management of Thalassemia
4, (a)Define Myocardial Infarction (2+2+6=10)
(b)Enlist the etiology and risk factors of MI
(C)Explain management of MI
5, (a)Define Anaemia (2+2+6=10)
(b)Classification of Anaemia
©Formulate nursing care plan for patient with Anaemia
(A) “Rules of nine” helps to identify the severity of...
Ans: Burn
(B) Leukaemia is…….
Ans: A cancer of blood and bone marrow
(C) Most common cause of MI
Ans: Coronary artery disease
(D) Common site of psoriasis includes
Ans: Elbow, knee and scalp
(E) TNM staging system refers to
Ans: Tumor, node and metastasis
Q.2 Choose TRUE and FALSE in the following statement (1X5=5)
6. The retina is the nerve layer located at the back of eye. (T)
7. Feeling of internal organ by finger pad is called manipulation. (F)
8. Extravasation refers to leakage of fluid into the tissues. (T)
9. Surgery is a most important aspect of management of burn in first 24 hours. (F)
10. Insect responsible for transmitting disease are called transmitter. (F)

Q.3 Fill in the blanks ( 1X5=5)

1. CPR stands for cardiopulmonary resuscitation.
2. Biopsy, is the small part of tissue for the diagnostic purposes.
3. Commonest cause of blindness in India cataract.
4. Inflammation of joint is called arthritis.
5. Causative agent of chicken pox varicella zoster.
Q.4Write the short notes on any 4 of the following. (4X5=20)
6. Radiation therapy
Ans: definition: radiation therapy is a type of cancer treatment that uses the beam of intense
energy to destroy the cancer cells.
Radiation therapy is a local treatment modality of treatment along with chemotherapy and surgery.
Uses of radiation therapy: (a) to cure cancer

● Destroy tumor that have not spread to the other body part.

● Reduce the risk that cancer will return after surgery

(b) to reduce symptoms

 ● Reduce the size of tumor that affect the
quality of life.

Types of radiation therapy: ● Alleviate pain by reducing the size.

I. External beam radiation therapy: it is also called teletherapy. With this technique, the
patient is exposed to radiation from a megavoltage treatment machine.
II. Internal beam radiation therapy: it is also called brachytherapy. It consist of
implantation or insertion of radioactive material directly into the tumor.
Side effect of radiation therapy:

● Skin changes: dryness, itching, blistering, or peeling.

● Fatigue

● Dry mouth, difficulty in swallowing, nausea, stiffness of jaw, tooth decay.

● Breast and nipple soreness

● Loss of appetite

● Diarrhoea

● Sexual problem

Care of the patient with radiation therapy

1. Nurse plan an important role in identifying, reporting and helping patient deal with
side effect of radiation therapy
2. Educating the patient and family about their treatment regimen supportive care and
expected outcome, side effect.
3. Management of problems caused by radiation therapy
a) Skin problems: provide health education regarding side effect, alert the patient
to potential skin changes, encourage patient to avoid sun exposure, Implement
symptomatic management as needed depending on specific skin effect
(application of lotion, benzoyl peroxide, corticosteroid cream).
b) GI problems and dry mouth: assessment of oral mucosa daily, encourage patient
to use artificial saliva, discourage use of irritant like tobacco, apply topical
anaesthetic in case of intense pain.
c) Leukopenia: monitor WBC count, teach patient for fever, and infection, advice
the patient avoid overcrowded area.
d) Loss of appetite: monitor weight at proper interval, encourage patient to use
 small, frequent meal of high protein and high calorie.
e) Fatigue: tell patient that fatigue is an expected side effect of the therapy,
encourage patient to rest when fatigue, to maintain usual lifestyle pattern.
 f) Diarrhoea: encourage fluid intake at least 3 litres, intake and output chart
maintenance, encourage for low fibre diet.
7. Tonsillitis
Ans- definition: Tonsillitis is inflammation of the tonsils, two oval-shaped pads of tissue at the
back of the throat — one tonsil on each side
Etiology and risk factors: Tonsillitis is most often caused by common viruses, but bacterial
infections also can be the cause. The most common bacterium causing tonsillitis is Streptococcus
pyogenes (group A streptococcus).
Young age, overcrowded area, opportunistic infection.
Types: acute tonsilitis, Chronic tonsilitis, recurrent
Clinical manifestation: Tonsillitis most commonly affects children between preschool ages and
the mid teenage years. Common signs and symptoms of tonsillitis include:

● Red, swollen tonsils

● White or yellow coating or patches on the tonsils

● Sore throat

● Difficult or painful swallowing

● Fever

● Enlarged, tender glands (lymph nodes) in the neck

● A scratchy, muffled or throaty voice

● Bad breath

● Neck pain or stiff neck

● Headache

Diagnostic tests:

a) History of sore throat

b) ENT examination
c) Throat swab culture

Management: medical management- antibiotic drug therapy, analgesics and antipyretics

Surgical management: tonsillectomy in case of recurrent tonsilitis

Nursing management: assessment

● Preadmission assessment. Much of the preoperative operations, including

laboratory studies, is done on a preadmission outpatient basis.

 ● History. Ask about any bleeding tendencies because postoperative bleeding is a

concern.

● Vital signs. Take and record vital signs to establish a baseline for postoperative

monitoring; the temperature is an important part of the data collection to

determine that the child has no upper respiratory infection

Goal of care:

● Preventing aspiration.

● Relieving pain, especially while swallowing.

● Improving fluid intake.

● Increase knowledge and understanding of post discharge care and possible

complications

● Prevent aspiration. Place the child in a partially prone position with head turned to one

side until the child is completely awake; encourage the child to expectorate all secretions;
discourage the child from coughing; and keep the head slightly lower than the chest to
help facilitate drainage of secretions.

● Relieve pain. Apply an ice collar postoperatively; administer pain medication as ordered;

encourage the caregiver to remain at the bedside to provide soothing reassurance; crying
irritates the raw throat and increases the child’s discomfort; thus, it should be avoided if
possible.

● Encourage fluid intake. When the child is fully awake from surgery, give small amounts

of clear fluids or ice chips; avoid irritating liquids such as orange juice and lemonade;
milk and ice cream products tend to cling to the surgical site and make swallowing more
difficult; thus they are poor choices; and record intake and output until adequate oral
intake is established.

● Provide family teaching. Instruct the caregiver to keep the child relatively quiet for a

few days after discharge; recommend giving soft foods and non-irritating liquids for the
first few days; teach family members to note any signs of haemorrhage and notify the
healthcare provider; and provide written instructions and telephone numbers before
discharge

8. Classification and complication of burn

Ans: classification of burn

● Superficial partial-thickness. The epidermis is destroyed or injured and a

portion of the dermis may be injured.

 ● Deep partial-thickness. A deep partial-thickness burn involves the destruction of

the epidermis and upper layers of the dermis and injury to the deeper portions of
the dermis.

● Full-thickness. A full-thickness burn involves total destruction of the epidermis

and dermis and, in some cases, the destruction of the underlying tissue, muscle,
and bone.
Complication of burns: immediate complications

● Ischemia. As edema increases, pressure on small blood vessels and nerves in the

distal extremities causes an obstruction of blood flow.

● Tissue hypoxia. Tissue hypoxia is the result of carbon monoxide inhalation.

● Respiratory failure. Pulmonary complications are secondary to inhalational

injuries
Delayed complication:

● Scars or ridged areas caused by an overgrowth of scar tissue (keloids)

● contracture

9. Psoriasis
Ans: definition: Psoriasis is a chronic, recurrent disease, marked by epidermal proliferation.
Its lesions, which appear as a erythematous papules and plaques covered with silver scales.

▪ This disorder commonly affects young adults, it may strike at any age, including

during infancy. It is characterized by recurring partial remissions and exacerbations.

Etiology and risk factors:

▪ Incidence is highest among whites.

▪ Hereditary

Clinical manifestation

▪ Lesions appear red, raised patches of skin covered with silvery scales(elbow, knee

and scalp)

▪ Patches are dry and may or may not itch

▪ Nail pitting, discoloration, crumbling beneath the free edges and separation of the
 nail plate

▪ Pruritus and pain

 ▪ Possibly arthritic symptoms (e.g. joint stiffness) Diagnostic

tests: history collection, physical examination, assessment,

Management: medical management

▪ Topical treatment is used to slow the overactive epidermis without affecting other

tissues

▪ Medications include tar preparations and anthralin, salicylic acid, and

corticosteroids. Medications may be in the form of lotions, ointments, pastes, creams

and shampoos
Phototherapy Psoralens and ultraviolet A (PUVA) therapy may be used for severely debilitating
psoriasis
Nursing management:
1. Administer prescribed medications, which may include coal tar therapy, and topical
corticosteroids.
2. Discuss and assist with the administration of additional medical treatments, which
may include coal tar shampoos, intralesional therapy (i.e. injection of medication
directly into lesion), systemic cytotoxic medication, phototherapoy, occlusive
dressing.
3. Enhance skin integrity
4. Prevent infection.
5. Provide client and family teaching

10. AIDS
Ans: definition: HIV or human immunodeficiency virus and acquired immunodeficiency
syndrome is a chronic condition that caused by HIV is a retrovirus isolated and recognized as the
etiologic agent of AIDS
mode of transmission:
HIV is transmitted through body fluids that contain free virions and infected CD4+, T cells.

● Sharing infected drug use equipment such as needles.

● Having sexual relations with infected individuals (both male and female).

● Blood transmission. Receiving HIV-infected blood or blood products especially

before blood screening.

● Maternal HIV. Infants born to mothers with HIV infection.

Diagnostic tests:
● CBC

● Serology
 ● Viral load

● Western blot test

● ELISA

● PCR

Medical management:

● Treatment of opportunistic infections. azithromycin or clarithromycin are

preferred prophylactic agents; for cryptococcal meningitis, the current primary

treatment is IV amphotericin B.

● Prevention of opportunistic infections. Antibiotic therapy

● Antidiarrheal therapy. .

● Antidepressant therapy.

● Nutrition therapy. For all AIDS patients who experience unexplained weight loss,

calorie counts should be obtained, and appetite stimulants and oral supplements
are also appropriate
Nursing management: assessment

● Nutritional status.

● Skin integrity.

● Respiratory status.

● Neurologic status.

● Fluid and electrolyte balance.

● Knowledge level.

Nursing intervention:

● Promote skin integrity. Patients are encouraged to avoid scratching; to use

nonabrasive, nondrying soaps and apply nonperfumed moisturizers; to perform

regular oral care; and to clean the perianal area after each bowel movement with
nonabrasive soap and water.

● Promote usual bowel patterns. The nurse should monitor for frequency and

consistency of stools and the patient’s reports of abdominal pain or cramping.

● Prevent infection. The patient and the caregivers should monitor for signs of
 infection and laboratory test results that indicate infection.

● Improve activity intolerance. Assist the patient in planning daily routines that

maintain a balance between activity and rest.

● Maintain thought processes. Family and support network members are

instructed to speak to the patient in simple, clear language and give the patient
sufficient time to respond to questions.
 ● Improve airway clearance. Coughing, deep breathing, postural drainage,

percussion and vibration is provided for as often as every 2 hours to prevent stasis
of secretions and to promote airway clearance.

● Relieve pain and discomfort. Use of soft cushions and foam pads may increase

comfort as well as administration of NSAIDS and opioids.

● Improve nutritional status. The patient is encouraged to eat foods that are easy

to swallow and to avoid rough, spicy, and sticky food items.

Q.5Answer any 4 in detail of following: (4X10=40)

1.(a)Define Glaucoma
Ans: Glaucoma or Increased intraocular pressure (IOP) is the result of inadequate drainage of
aqueous humor from the anterior chamber of the eye. (2+3+5=10)
(b) Enlist the causes of Glaucoma
Optic nerve damage

● Having high internal eye pressure (intraocular pressure)

● Being over age 60

● Being black, Asian or Hispanic

● Having a family history of glaucoma

● Having certain medical conditions, such as diabetes, heart disease, high blood

pressure and sickle cell anaemia

● Having corneas that are thin in the centre

● Being extremely near sighted or farsighted

● Having had an eye injury or certain types of eye surgery

● Taking corticosteroid medications, especially eyedrops, for a long time

(c) Explain medical, surgical and nursing management of Glaucoma

Medical management:
The damage caused by glaucoma can't be reversed. But treatment and regular check-ups can help
slow or prevent vision loss, especially if you catch the disease in its early stages.
Glaucoma is treated by lowering your eye pressure (intraocular pressure). Depending on your
situation, your options may include prescription eyedrops, oral medications, laser treatment,
surgery or a combination of any of these.
Eyedrops
Glaucoma treatment often starts with prescription eyedrops. Prescription
eyedrop medications include:

● Prostaglandins.

● Beta blockers. .

● Alpha-adrenergic agonists.

● Carbonic anhydrase inhibitors.

● Rho kinase inhibitor.

● Miotic or cholinergic agents.

● Trabeculoplasty. .

● Iridotomy.

● Trabeculectomy

Nursing management:

● Determine type and degree of visual loss

● Allow expression of feelings about loss and possibility of loss of vision.

● Implement measures to assist patient to manage visual limitations such as reducing

clutter, arranging furniture out of travel path; turning head to view subjects; correcting for
dim light and problems of night vision

● Demonstrate administration of eye drops (counting drops, adhering to the schedule, not
missing doses)

● Evaluate anxiety level, degree of pain experienced or suddenness of onset of symptoms,

and current knowledge of the condition

● Provides an opportunity for the patient to deal with the reality of the situation, clarify
problems, and problem-solve concerns

● Demonstrate proper technique for administration of eye drops, gels, or discs. Have the
patient perform a return demonstration

● Identify potential side effects and adverse reactions of treatment such as decreased

appetite, nausea, and vomiting, fatigue, “drugged” feeling, decreased libido, impotence,
cardiac irregularities, syncope, heart failure (HF)
● Reinforce avoidance of activities such as heavy lifting and pushing, snow shoveling,
wearing tight or constricting clothing

● Advise patient to immediately report severe eye pain, inflammation, increased

photophobia, increased lacrimation, changes in the visual field, veil-like curtain, blurred
vision, flashes of light and particles floating in the visual field
2. (a)Explain classification and causes of Fracture
Ans: classification

⮚ Pathological fracture

⮚ Non pathological fracture

⮚ Complete fracture. A complete fracture involves a break across the entire cross- section

of the bone and is frequently displaced.

⮚ Incomplete fracture. An incomplete fracture involves a breakthrough only part of the

cross-section of the bone.

⮚ Comminuted fracture. A comminuted fracture is one that produces several bone

fragments.

⮚ Closed fracture. A closed fracture is one that does not cause a break in the skin.

⮚ Open fracture. An open fracture is one in which the skin or mucous membrane wound

extends to the fractured bone

⮚ Oblique fracture

⮚ Hairline fracture

Causes of fracture

● Direct blows. Being hit directly by a great force could cause fractures in the

bones.

● Crushing forces. Forces that come into contact with the bones and crush them

could also result in fractures.

● Sudden twisting motions. Twisting the joints in a sudden motion leads to

fractures.

● Extreme muscle contractions. When the muscles have reached their limit in

contraction, it could lead to serious fractures

(b) Explain management of Fracture

Ans: management
● Immediately after injury, if a fracture is suspected, it is important to immobilize

the body part before the patient is moved.

● Adequate splinting is essential to prevent the movement of fracture fragments.

● In an open fracture, the wound should be covered with a sterile dressing to

prevent contamination of the deeper tissues.

 ● Fracture reduction refers to the restoration of the fracture fragments to anatomic

alignment and positioning and can be open or closed depending on the type of
fracture
Assessment of the fractured area includes the following:

● Close fracture. The patient with close fracture is assessed for absence of opening

in the skin at the fracture site.

● Open fracture. The patient with open fracture is assessed for risk for

osteomyelitis, tetanus, and gas gangrene.

● The fractured site is assessed for signs and symptoms of infection

Nursing diagnosis:

● Acute pain related to fracture, soft tissue injury, and muscle spasm.

● Impaired physical mobility related to fracture.

● Risk for infection related to opening in the skin in an open fracture.

● The nurse should instruct the patient regarding proper methods to control edema

and pain.

● It is important to teach exercises to maintain the health of the unaffected muscles

and to increase the strength of muscles needed for transferring and for using
assistive devices.

● Plans are made to help the patients modify the home environment to promote

safety such as removing any obstruction in the walking paths around the house.

● Wound management. Wound irrigation and debridement are initiated as soon as

possible.

● Elevate extremity. The affected extremity is elevated to minimize edema.

● Signs of infection. The patient must be assessed for presence of signs and

symptoms of infection

3. (a)Define Thalassemia
Ans: The term thalassemia is applied to a variety of inherited blood disorders characterized by
deficiencies in the rate of production of specific globin chains in hemoglobin (2+4+4=10)
(b) Pathophysiology of Thalassemia.
 (c) Medical and nursing management of Thalassemia
Ans: medical management:

● Splenectomy. Splenectomy is the principal surgical procedure used for many

patients with thalassemia.

● Transfusions. Transfusions are the foundation of medical management; recent

studies have evaluated the benefits of maintaining the child’s hemoglobin level
above 10g/dl, a goal that may require transfusions as often as every 2-4 weeks.

● Bone marrow transplantation. Bone marrow transplantation offers the

possibility of a cure for some children with thalassemia, either using marrow from
an unaffected sibling, or a matched, unrelated donor.

● Diet. A normal diet is recommended, with emphasis on the following

supplements: folic acid, small doses of ascorbic acid (vitamin C), and alpha-
tocopherol (vitamin E); iron should not be given, and foods rich in iron should be
avoided

● Antipyretics. Administration before blood transfusion prevents or decreases febrile

reactions.

● Antihistamines. Administration prior to blood transfusion may decrease or prevent

allergic reactions.

● Chelating agents. These agents are used to chelate excessive iron from the body in

patients with iron overload.

● Corticosteroids. Some patients may develop a local reaction at the site of DFO injection;

hydrocortisone in the DFO solution may help to reduce the reaction.

● Antibacterial combinations. Certain antibacterial agents are known to be effective

against organisms that often cause infection in patients with iron overload who also are
receiving DFO therapy
Nursing management: assessment

● Thalassemia major. Assess for severe anemia, splenomegaly or hepatomegaly

with abdominal enlargement, frequent infections, bleeding tendencies e.g.

epistaxis, and anorexia.

● Thalassemia intermediate. Assess for anemia, jaundice, and splenomegaly,

hemosiderosis caused by increased intestinal absorption of iron.

 ● Thalassemia minor. Assess for mild anemia usually with no signs or symptoms

Nursing intervention:
 ● Activity. Assist the client in planning and prioritizing activities of daily living

(ADL); assist the client in developing a schedule for daily activity and rest; and
stress the importance of frequent rest periods.

● Health education. Explain the importance of the diagnostic procedures (such as

complete blood count), bone marrow aspiration and a possible referral to a

hematologist; and explain the hematological vocabulary and the functions of
blood elements, such as white blood cells, red blood cells, and platelets.

● Prevent infection. Assess for local or systemic signs of infection, such as fever,

chills, swelling, pain, and body malaise; instruct the client to avoid contact with
people with existing infections; instruct the client to avoid eating raw fruits and
vegetables and uncooked meat; stress the importance of daily hygiene, mouth
care, and perineal care; and teach the client and visitors the proper handwashing.

● Prevent bleeding. Assess for any frank bleeding from the nose, gums, vagina, or

urinary or gastrointestinal tract and monitor platelet count.

4. (a)Define Myocardial Infarction

Ans: MI defined as condition which is caused by reduced blood supply in coronary artery
due to atherosclerosis and occlusion of artery by thrombus or embolus. (2+2+6=10)
(b) Enlist the etiology and risk factors of MI
Ans: The causes of MI primarily stems from the vascular system.

● Vasospasm. This is the sudden constriction or narrowing of the coronary artery.

● Decreased oxygen supply. The decrease in oxygen supply occurs from acute

blood loss, anemia, or low blood pressure.

● Increased demand for oxygen. A rapid heart rate, thyrotoxicosis, or ingestion of

cocaine causes an increase in the demand for oxygen

Risk factors

⮚ Family history

⮚ Older age

⮚ Hypertension

⮚ Diabetes mellitus
⮚ Tobacco

⮚ Intake of high cholesterol

 ⮚ Sedentary life style

⮚ Stress and obesity

(c) Explain diagnostic tests and management of MI

Ans: diagnostic tests

✔ History collection

✔ Physical examination

✔ Chest x ray

✔ Angiography

✔ Troponin I, T

✔ ECG

✔ Echocardiogram

Management:

● Morphine administered in IV boluses is used for MI to reduce pain and anxiety.

● ACE Inhibitors. ACE inhibitors prevent the conversion of angiotensin I to

angiotensin II to decrease blood pressure and for the kidneys to secrete sodium
and fluid, decreasing the oxygen demand of the heart.

● Thrombolytics. Thrombolytics dissolve the thrombus in the coronary

artery,allowing blood to flow through the coronary artery again, minimizing the
size of the infarction and preserving ventricular function.

● Assess for chest pain not relieved by rest or medications.

● Monitor vital signs, especially the blood pressure and pulse rate.

● Assess for presence of shortness of breath, dyspnea, tachypnea, and crackles.

● Assess for nausea and vomiting.

● Assess for decreased urinary output.

● Assess for the history of illnesses.

● Perform a precise and complete physical assessment to detect complications and changes

in the patient’s status.

● Assess IV sites frequently

● Administer oxygen along with medication therapy to assist with relief of symptoms.

● Encourage bed rest with the back rest elevated to help decrease chest discomfort and

dyspnea.

● Encourage changing of positions frequently to help keep fluid from pooling in the bases

of the lungs.

● Check skin temperature and peripheral pulses frequently to monitor tissue perfusion.

● Provide information in an honest and supportive manner.

 ● Monitor the patient closely for changes in cardiac rate and rhythm, heart sounds, blood

pressure, chest pain, respiratory status, urinary output, changes in skin color, and
laboratory values
5. (a)Define Anaemia
Ans: Anemia is the most common hematologic disorder in which the hemoglobin level is lower
than normal, reflecting the presence of a decrease in number or derangement in functionof red
blood cells (2+2+6=10)
(b) Classification of Anaemia
Ans: Anemia may be classified roughly into on the basis of Hb level:

1. Severe anemia when the Hb is <7 g/dL.

2. Moderate when the Hb is 7 to 10 g/dL. This group will not produce evident S/S. in most
of the cases.
3. Mild anemia when Hb is 10 g/dL – 12.7 g/dl
Based on RBC morphology:

1. Normochromic and normocytic anemias are due to:

1. Anemia of acute hemorrhage.
2. Hemolytic anemia.
3. Anemia due to chronic diseases.
2. Hypochromic and microcytic anemias are due to:
1. Iron deficiency anemia.
2. Thalassemia.
3. Normochromic and macrocytic anemias are due to:
1. Vit. B12 deficiency.
2. Folate deficiency.
Anemia classification based on physiological abnormality:

1. Defective maturation of erythropoiesis.

2. Hemolytic anemia where is the increased breakdown of the RBCs.
3. Defect due to an increase in RBC precursors as compared to the degree of anemia.
Amenia classification based on etiology:

1. Increased RBCs destruction due to intra or extra red blood cell defects.
2. Increased blood loss, which may be acute or chronic.
3. Defective RBCs formation due to Lake of factors necessary for erythropoiesis.
 Anemia classification based on the category:

1. increased destruction of the RBCs

1. Hemolytic anemia (nonimmune).
2. Immune hemolytic anemia.

(c) Formulate nursing care plan for patient with Anaemia

Nursing diagnosis Intervention:
Assess the specific cause of fatigue.
Assess the client’s ability to perform activities of daily living (ADLs), and the demands of daily
living
Assess the client’s ability to perform activities of daily living (ADLs), and the demands of daily
living
Assist the client in planning and prioritizing activities of daily living (ADL)
Assist the client in developing a schedule for daily activity and rest. Stress the importance of
frequent rest periods
Provide supplemental oxygen therapy, as needed Anticipate
the need for the transfusion of packed RBCs
Explain the importance of the diagnostic procedures (such as complete blood count), bone marrow
aspiration and a possible referral to a hematologist
Explain the hematological vocabulary and the functions of blood elements, such as white blood
cells, red blood cells, and platelet
Educate the client and the family regarding food rich in iron, folic acid, and vitamin B12 Educate
the client and the family regarding replacement therapy with folic acid and iron