Nursing Intervention Classification and North American Nursing Diagnosis Association

Introduction

Anemia is a hematological disorder that occurs when there is a reduction in the concentration of red blood cells in the blood. The reduced concentration of red blood cells affects the physiological transport of oxygen in the body. According to Kassebaum et al. (2014), anemia contributes 8.8% of disability cases globally and mainly affects women and children aged less than five years. In this view, anemia still poses a significant challenge to the health care systems across the world. Hence, nurses need to understand standardized terminologies in nursing practice so that they can develop appropriate diagnoses, apply relevant interventions, and achieve expected outcomes, according to the guidelines of the North American Nursing Diagnosis Association (NANDA), Nursing Intervention Classification (NIC), and Nursing Outcome Classification (NOC). To describe elements of NANDA, NIC, and NOC, the essay selects a scenario of a patient, Ms. A, who suffers from iron deficiency anemia. The patient regularly experiences signs and symptoms of anemia, such as dizziness, fatigue, weakness, malaise, breathlessness, and palpitations. Her medical history shows that she has suffered from menorrhagia and dysmenorrhea for a period of over ten years. To relieve pain, Ms. A stated that she has been taking aspirin every 3-4 hours during her menstruation period. Therefore, the essay identifies elements of NANDA, NIC, and NOC that are applicable in this scenario, gives detailed explanation of data, information, knowledge, and wisdom, and concludes by providing a summary of pertinent insights.

NANDA, NIC, and NOC Elements

Analysis of the scenario using NANDA nursing diagnoses indicates that imbalanced nutrition, deficient knowledge, impaired walking, and fatigue are some of the elements, which relate to the condition of the patient. Imbalanced nutrition is an important element of NANDA, which explains the occurrence of iron deficiency anemia. John-Wimbley and Graham (2011) state that chronic loss of blood and insufficient intake of iron result in iron deficiency anemia. Moreover, the deficient knowledge of nutrition and the consumption of medications such as non-steroidal anti-inflammatory drugs contribute to the occurrence of iron deficiency anemia. According to a study done among adult women, a regular dosage of aspirin causes gastrointestinal bleeding (Huang, Strate, Ho, Lee, & Chan, 2011). If gastrointestinal bleeding occurs for a long period, it will cause chronic loss of blood leading to iron deficiency anemia. Impaired walking and fatigue are some of the effects of iron deficiency anemia among individuals.

Nutritional management is one of the NIC elements, which is central to the management of iron deficiency anemia. Increasing the intake of iron through the consumption of iron-rich food and intake of iron supplements constitute the first line of therapy in the management of iron deficiency anemia (John-Wimbley & Graham, 2011). Usually, intake of iron supplements is a short-term intervention of managing iron deficiency anemia. Given that the normal source of iron is food, the consumption of iron-rich food provides a long-term intervention of managing iron-deficiency anemia. In the aspect of deficient knowledge, nutritional counseling is another NIC element that enables the patient to understand the management of iron deficiency anemia using diet. Since the regular dosage of aspirin leads to gastrointestinal bleeding and blood loss, Health education is an appropriate NIC intervention, which aids the patient to choose safe painkillers and relieve dysmenorrhea. Moreover, health education is essential knowledge in the treatment and management of menorrhagia and dysmenorrhea. Body mechanics promotion is a NIC element that aids in relieving fatigue and impaired walking, which are the effects of iron deficiency anemia.

The NOC elements that are applicable in the measurement of outcomes in this case study are nutritional status, nutrient intake, biochemical measures, medication knowledge, personal safety, and self-care. Given that given that the intervention of iron deficiency anemia entails consumption of iron-rich food and intake of iron supplements, assessment of nutritional status determines the bioavailability of iron in food and iron supplements. The presence of vitamin C in food increases bioavailability of iron, while the presence of tannins and phytates decrease bioavailability of iron (John-Wimbley & Graham, 2011). The element of nutrient intake is also an important NIC outcome because it assesses the amount of iron consumed relative to other nutrients. The amount of iron intake and the pattern of intake in terms of frequency influence the management of iron deficiency anemia. Biochemical measurement of hemoglobin level is an element that directly assesses the outcome of NIC interventions. When the hemoglobin levels for men and women fall below 7.7 mmol/l and 7.4 mmol/l, respectively, they become anemic (John-Wimbley & Graham, 2011). Complete blood count normally indicates the level of hemoglobin relative to other blood cells. Regarding the use of medications such as aspirin, the NIC outcomes are the knowledge of medications and personal safety. These forms of knowledge are central to the management of iron deficiency anemia, as well as menorrhagia and dysmenorrhea.

Guiding Data, Information, Knowledge, and Wisdom

The standardized terminologies in terms of NANDA, NIC, and NOC elements provide pertinent data and information. In the nursing diagnosis of iron deficiency anemia, the pertinent data and information are the causes of anemia such as insufficient intake of iron and chronic loss of blood. The knowledge of the prevalence of anemia among women forms the basis of associating iron deficiency anemia with menorrhagia. Ibrahim et al. (2012) state that women with severe menorrhagia are prone to experience iron deficiency anemia. Given that the patient has been experiencing menorrhagia for 10 years and has been taking aspirin to relieve the pain, the knowledge of the effects of non-steroidal anti-inflammatory drugs led to the revelation that aspirin contributed to the blood loss. Huang et al. (2011) report that regular use of aspirin causes iron deficiency anemia through gastrointestinal bleeding. The management of iron deficiency anemia requires the consumption of iron supplements as a short-term intervention and the intake of iron-rich food as a long-term intervention. Moreover, education of the patient regarding nutritional intake is another important intervention. Assessment of nutritional status, nutritional intake, medication knowledge, personal safety, and measurement of hemoglobin level are NOC outcomes, which require knowledge and wisdom in their assessment. Overall, the knowledge and wisdom of iron deficiency anemia guide in the formulation of NIC interventions and NOC outcomes.

Conclusion

The analysis of the scenario using NANDA, NIC, and NOC elements gives important insights about the causes, interventions, and outcomes of iron deficiency anemia. In this case, the analysis of the scenario indicates that the patient suffers from iron deficiency anemia due to the chronic loss of blood through menorrhagia, gastrointestinal bleeding owing to the use of aspirin, and deficient intake iron-rich food. Since NANDA, NIC, and NOC offer standardized terminologies in nursing practice, they enhance conceptualization of the scenario. The NANDA elements applicable in the scenario are imbalanced nutrition, deficient knowledge, impaired walking, and fatigue. The NIC elements such as nutritional status, nutrient intake, health education, and nutritional counseling are also applicable in this scenario since they interlink with the NANDA elements. Nutritional status, nutrient intake, biochemical measures, medication knowledge, personal safety, and self-care are NOC elements that are applicable in the assessment of the scenario. Generally, NANDA, NIC, and NOC elements interlink in determining nursing diagnoses, interventions, and outcomes.

References

Huang, E., Strate, L., Ho, W., Lee, S., & Chan, A. (2011). Long-term use of aspirin and the risk of gastrointestinal bleeding. American Journal of Medicine, 124(5), 426-433.

Ibrahim, R., Khan, A., Raza, S., Kafeel, M., Dabas, R., Haynes, G., … Zaman, M. (2012). Triad of iron deficiency anemia, severe thrombocytopenia and menorrhagia: A case report and literature review. Clinical Medicine Insights, 5(1), 23-27.

John-Wimbley, T., & Graham, D. (2011). Diagnosis and management of iron deficiency anemia in the 21st century. Therapeutic Advances in Gastroenterology, 4(3), 177-184.

Kassebaum, J., Jasrasaria, R., Naghavi, M., Wulf, K., Johns, N., Regan, M., … Murray, J. (2014). A Systematic analysis of global burden from 1990 to 2010. Blood, 123(5), 615-624.