A Comprehensive Case Report: Managing Severe HemolyticAnemia with Collaborative Medical and Nursing Interventions

Abstract

Assessment: A 30-year-old woman with severe hemolytic anemia arrived at the ER with a critically low hemoglobin level of 2.1 g/dL, leading to an immediate packed red blood cell transfusion. After stabilization, she was moved to the ICU due to her deteriorating condition. The assessment covered respiratory health, cardiovascular markers, fluid/nutrition balance, physical exam, and X-ray results. Importantly, her Glasgow Coma Scale score showed altered consciousness.
Diagnosis: Based on the comprehensive assessment, a range of nursing diagnoses were formulated according to the North American Nursing Diagnosis Association (NANDA) 2021-2023. These included Impaired Gas Exchange due to low Hb levels, Risk for Bleeding stemming from decreased red blood cell (RBC) count, Risk for Infection owing to compromised immunity, Activity Intolerance due to severe anemia, and Anxiety prompted by critical illness and unfamiliar surroundings.
Planning: The care plan targeted interventions for each nursing diagnosis. To address Impaired Gas Exchange, we closely monitored respiration and adjusted ventilator settings. For Risk of Bleeding, we took bleeding precautions, handling gently and tracking coagulation. To prevent Infection, we prioritized aseptic methods and temperature checks. For Activity Intolerance, we used Activity Therapy and gradual progression. To ease Anxiety, we applied techniques to reduce psychological stress.
Discussion: This case stressed the urgency of interventions for severe hemolytic anemia. The patient's critical state led to immediate PRC transfusion and ICU transfer. Cardiovascular and oxygen-carrying interplay showed in physiological signs. Nursing diagnoses and care planning revealed holistic care needs. Altered GCS and lab values steered interventions, urging interdisciplinary teamwork. Radiography showed heart response to chronic anemia. The discussion emphasized precise assessment, diagnoses, and planning for intricate conditions like severe hemolytic anemia.