Anemia

OT Dude Academy’s Free NBCOT® Exam Prep Course Hematology Anemia
  • Characterized by a decrease in hemoglobin level from baseline.
  • Can be temporary or chronic; mild to severe.
  • Hemoglobin levels are lower in women and African American men.1 
  • For children, anemia is defined as hemoglobin less than the 5th percentile for age.2 
  • Can have an adverse impact on hospitalization, disability, and mortality for older adults.3 4 5 6 7 8 9 
  • Causes10 
    • Nutrient deficiency, e.g., iron, folate, vitamin B1211 
    • Chronic kidney disease
    • Chronic disease or inflammation
    • Unexplained
  • Types12 
    • Aplastic: bone marrow contains damaged stem cells.
    • Hemolytic: body destroys red blood cells prematurely.
    • Normocytic: low red blood cell count
    • Pernicious: lack of B12 and shortage of healthy RBCs
    • Sickle cell: genetic disease characterized by abnormal RBCs.
  • Symptoms: paleness, dyspnea, cold hands and feet, headaches, dizziness, irregular heartbeat, pica.12 
  • Treatment: blood transfusion and treating the underlying cause.2 
  • Consider holding therapy, depending on the severity of symptoms, critical lab values [hemoglobin, platelet, WBC], communication with other healthcare providers, and professional judgment. Other factors include body temperature, glucose level, patient appearance, vital signs, level of consciousness, neurological contraindications, orthopedic contraindications, DVT/PE rule-out, and patient consent. 13 14 
  1. Tefferi, A. (2003, October). Anemia in adults: a contemporary approach to diagnosis. In Mayo Clinic Proceedings (Vol. 78, No. 10, pp. 1274-1280). Elsevier.[↩]
  2. Janus, J., & Moerschel, S. K. (2010). Evaluation of anemia in children. American family physician, 81(12), 1462-1471.[↩][↩]
  3. Chaves PH, Xue QL, Guralnik JM, Ferrucci L, Volpato S, Fried LP. What constitutes normal hemoglobin concentration in community-dwelling disabled older women? J Am Geriatr Soc. 2004;52:1811–1816.[↩]
  4. Culleton BF, Manns BJ, Zhang J, Tonelli M, Klarenbach S, Hemmelgarn BR. Impact of anemia on hospitalization and mortality in older adults. Blood. 2006;107:3841–3846.[↩]
  5. Denny SD, Kuchibhatla MN, Cohen HJ. Impact of anemia on mortality, cognition, and function in community-dwelling elderly. Am J Med. 2006;119:327–334.[↩]
  6. Izaks GJ, Westendorp RG, Knook DL. The definition of anemia in older persons. JAMA. 1999;281:1714–1717.[↩]
  7. Patel KV, Harris TB, Faulhaber M, Angleman SB, Connelly J, Bauer DC, et al. Racial variation in the relationship of anemia with mortality and mobility disability among older adults. Blood. 2007;109:4663–4670.[↩]
  8. Penninx BW, Pahor M, Woodman RC, Guralnik JM. Anemia in old age is associated with increased mortality and hospitalization. J Gerontol A Biol Sci Med Sci. 2006;61:474–479.[↩]
  9. Zakai NA, Katz R, Hirsch C, Shlipak MG, Chaves PH, Newman AB, et al. A prospective study of anemia status, hemoglobin concentration, and mortality in an elderly cohort: the Cardiovascular Health Study. Arch Intern Med. 2005;165:2214–2220.[↩]
  10. Patel, K. V. (2008, October). Epidemiology of anemia in older adults. In Seminars in hematology (Vol. 45, No. 4, pp. 210-217). WB Saunders.[↩]
  11. Semba, R. D., Ricks, M. O., Ferrucci, L., Xue, Q. L., Chaves, P., Fried, L. P., & Guralnik, J. M. (2007). Types of anemia and mortality among older disabled women living in the community: the Women’s Health and Aging Study I. Aging clinical and experimental research, 19(4), 259-264.[↩]
  12. American Academy of Family Physicians. (2021). What is Anemia? Retrieved from https://familydoctor.org/condition/anemia/[↩][↩]
  13. Stiller K, Phillips A: Safety aspects of mobilizing acutely ill inpatients. Physiotherapy Theory and Practice. 2003; 19: 239-257.[↩]
  14. Stiller K: Safety issues that should be considered when mobilizing critically ill patients. Crit Care Clin. 2007; 23:35-53.[↩]
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