Anemia, Sickle Cell, and Hemophilia: What Every Nurse Needs to Know

It’s Time to Talk About Blood Disorders

If you are in nursing school or already practicing, you know this much—blood keeps everything running. It carries oxygen, fights infection, and helps the body heal. But what happens when the blood itself is the problem? What happens when oxygen doesn’t reach the tissues, when clotting doesn’t happen, when patients are in pain that won’t stop?

This is where anemia, sickle cell disease, and hemophilia take center stage. These aren’t just textbook conditions. These are real-life battles that millions of people fight every single day.

Understanding Anemia: When Oxygen Falls Short

Anemia is not just about low hemoglobin—it’s about low energy, low oxygen, and low quality of life. When patients say they feel tired, weak, dizzy, or short of breath, listen closely. Anemia is not just a lab value. It is a sign that something bigger is going on.

Types of Anemia Every Nurse Should Know

Iron-Deficiency Anemia

• The most common type of anemia worldwide
• Caused by blood loss, poor diet, pregnancy, or absorption issues
• Patients often crave ice, dirt, or starch (pica)
• Treatment includes iron supplements, dietary changes, or IV iron

Vitamin B12 Deficiency (Pernicious Anemia)

• Caused by lack of intrinsic factor or poor dietary intake
• Symptoms include glossitis, neurological issues, and fatigue
• Treated with B12 injections or high-dose oral supplementation

Folate Deficiency Anemia

• Often seen in alcoholism, pregnancy, or malnutrition
• Similar to B12 deficiency but without neurological symptoms
• Treated with folic acid supplements and dietary adjustments

Aplastic Anemia

• Bone marrow failure leads to pancytopenia (low RBCs, WBCs, and platelets)
• Causes include autoimmune disorders, toxins, or chemotherapy
• Patients are at high risk for infection and bleeding
• Treated with bone marrow transplant or immunosuppressants

Hemolytic Anemia

• Red blood cells are destroyed too quickly
• Can be autoimmune (as in lupus) or caused by medications, infections, or genetic conditions
• Patients often have jaundice, dark urine, and an enlarged spleen
• Treatment depends on the cause but may include steroids, transfusions, or splenectomy

When a patient is anemic, the priority is oxygenation, fluid balance, and treating the root cause. These patients can decompensate quickly, and you need to stay ahead of it.

---

Sickle Cell Disease: When Pain is More Than Pain

If you have ever cared for a patient in sickle cell crisis, you know this—it is unrelenting, deep, excruciating pain. And here’s what every nurse must understand: this pain is real. This disease is real. And these patients need real care, not judgment.

What is Sickle Cell Disease?

Sickle cell disease is a genetic disorder where red blood cells become crescent-shaped, making it hard for them to carry oxygen and move through blood vessels. This leads to pain, organ damage, and a lifetime of medical challenges.

Triggers for a Sickle Cell Crisis

• Infection
• Dehydration
• Cold temperatures
• Overexertion
• Stress
• High altitudes

Managing a Sickle Cell Crisis in Nursing

1. Pain Control is Non-Negotiable – Opioids are often necessary. Do not delay pain management.
2. Hydration is Essential – IV fluids help reduce sickling.
3. Oxygen Therapy – Only if the patient is hypoxic.
4. Infection Prevention – These patients are at high risk for infection due to spleen damage.
5. Blood Transfusions – Used in severe cases to prevent stroke or acute chest syndrome.

Patients with sickle cell disease face discrimination in healthcare. Be the nurse who believes them, who advocates for them, who treats them with dignity.

Hemophilia: When Blood Won’t Clot

Now let’s talk about hemophilia, a bleeding disorder that turns minor injuries into major medical emergencies. Hemophilia is a genetic disorder where the body lacks clotting factors, leading to spontaneous bleeding, easy bruising, and joint damage.

Types of Hemophilia

• Hemophilia A – Deficiency of Factor VIII
• Hemophilia B – Deficiency of Factor IX
• Hemophilia C – Deficiency of Factor XI (less common)

Nursing Priorities for a Hemophilia Patient

• Bleeding Precautions – No aspirin, no NSAIDs, no IM injections.
• Factor Replacement Therapy – Patients often need Factor VIII or IX infusions to stop bleeding.
• Injury Prevention – Soft toothbrushes, electric razors, and fall prevention are critical.
• Monitor for Hemarthrosis – Bleeding into joints is a major cause of disability in hemophilia.

These patients know their bodies well. When they say they need factor replacement, do not delay treatment. The faster the clotting factor is given, the less damage is done.

Nurses Are the Lifeline

Anemia, sickle cell disease, and hemophilia are not just conditions. They are lifelong battles, and nurses are on the front lines. Your knowledge, your compassion, your ability to act fast and advocate fiercely—this is what saves lives.

The next time you see an anemic patient struggling to breathe, a sickle cell patient  in pain, or a hemophilia patient with a swollen, bleeding joint, remember:

You have the power to ease suffering. You have the knowledge to save lives.

Want to Master Blood Disorders for Nursing School?

• Bookmark this guide for quick reference.
• Share it with fellow nursing students and nurses.
• Comment below: What’s your biggest challenge when caring for patients with blood disorders?