NANDA-I 2024-2026 edition · Reviewed November 2, 2026 by the editorial team
What happens in anemia and where nursing comes in
With less hemoglobin, less oxygen reaches the tissues: the patient gets tired easily, short of breath on exertion, pale, dizzy and tachycardic. Nursing paces activity, prevents falls, supports nutrition and teaches the treatment plan.
What to assess
- Hemoglobin and hematocrit as ordered.
- Fatigue, dyspnea and tachycardia on exertion.
- Pallor of the skin, mucous membranes and nail beds; capillary refill.
- Dizziness when getting up and fall risk.
- Diet: iron, protein and appetite.
- What the patient knows about their treatment and warning signs.
NANDA-I 2024-2026 nursing diagnoses for anemia
| Code | Diagnosis | When it applies |
|---|---|---|
| 00477 | Excessive fatigue burdenProblem-focused · former code 00093 | Tiredness that does not improve with rest and limits daily activities. |
| 00298 | Decreased activity toleranceProblem-focused | Dyspnea, tachycardia or dizziness with usual activities. |
| 00204 | Ineffective peripheral tissue perfusionProblem-focused | Pallor, cool extremities and slow capillary refill from reduced oxygen delivery. |
| 00303 | Risk for adult fallsRisk | Dizziness and weakness raise the chance of falling, especially in older adults. |
| 00343 | Inadequate nutritional intakeProblem-focused · former code 00002 | Iron-poor diet or low appetite in nutritional anemias. |
| 00435 | Inadequate health knowledgeProblem-focused · former code 00126 | Does not know how to take iron supplements or which foods help. |
How to prioritize them
Activity tolerance and safety (falls) first, then fatigue and nutrition, and discharge teaching last. Your assessment makes the final call: anything that threatens life (airway, breathing, circulation) comes first.
Sample nursing diagnosis statements
Excessive Fatigue Burden related to fragmented sleep and insufficient protein and iron intake as evidenced by tiredness rated 8/10 that does not improve with sleep, 2-hour naps without regaining energy, and giving up household tasks for the past 3 weeks.
Decreased activity tolerance related to prolonged bed rest and inadequate oxygenation during exertion as evidenced by HR increase of 32 bpm when walking 10 meters, SpO2 of 87% while ambulating, and Borg dyspnea score of 6/10.
Ineffective peripheral tissue perfusion related to active smoking and lack of knowledge about foot care as evidenced by weak dorsalis pedis pulses, capillary refill of 4 seconds, a cool right foot, and calf pain after walking 100 meters that eases with rest.
Risk for adult falls related to dizziness on rising, inappropriate footwear and nighttime urinary urgency, in a 78-year-old patient on diuretics and antihypertensives (associated condition).
Inadequate nutritional intake related to uncontrolled nausea and pain with eating and lack of knowledge of the prescribed diet as evidenced by intake of less than 50% of meals for 4 days and weight loss of 4 kg (6%) in 3 weeks.
Inadequate Health Knowledge regarding insulin management related to information given in technical terms without supervised practice as evidenced by incorrect injection technique on return demonstration, inability to identify symptoms of hypoglycemia, and stating that they skip the dose when they do not eat.
Fictional cases written by our team. Adapt them to your patient with the PES statement generator.
Nursing care plan summary
Main goals and interventions for the priority diagnoses. Each diagnosis page has the full plan, with rationales and a case study.
Excessive fatigue burden (00477)
Goals
- Patient reports fatigue ≤ 4/10 on a numeric scale within 2 weeks.
- Patient sleeps at least 6 hours a night with no more than 2 awakenings within 1 week.
Interventions
- Rate fatigue every day on the same 0-10 scale and record how it varies.
- Ask the patient to keep an activity and energy diary.
- Plan important tasks with the patient for their peak energy hours, with breaks in between.
- Improve sleep conditions: cluster nighttime care, reduce noise and light, avoid long afternoon naps.
Decreased activity tolerance (00298)
Goals
- Walks 30 meters on prescribed oxygen with SpO2 ≥ 90% and HR no more than 20 bpm above baseline within 72 hours.
- Returns to baseline HR and SpO2 within 5 minutes after activity within 48 hours.
Interventions
- Measure HR, BP, RR and SpO2 before, during and 3-5 minutes after each activity.
- Stop the activity if SpO2 drops below target (generally 90%; 88% in COPD if ordered), HR rises more than 20-30 bpm above baseline, systolic BP drops, or chest pain, dizziness or severe dyspnea appear. Notify the provider if it does not resolve with rest.
- Increase activity in stages: sitting on the edge of the bed, transferring to the chair, standing, walking in the room and then in the hallway.
- Alternate activities with rest periods and avoid scheduling bathing, dressing changes and tests back to back.
Ineffective peripheral tissue perfusion (00204)
Goals
- Cuts smoking in half within 4 weeks and quits within 3 months, with support from a cessation program.
- Walks 30 minutes at least 5 days a week, pausing when pain appears, starting in the first month.
Interventions
- Assess and document pulses, temperature, color and capillary refill in both feet at every visit or shift.
- Inspect the feet for wounds, cracks, calluses or color changes.
- Teach daily foot care: wash and dry between the toes, moisturize without putting lotion between them, cut nails straight across, never walk barefoot and check inside shoes before putting them on.
- Encourage daily walking: walk until moderate pain appears, rest, then continue.
Build the full care plan as a table with the generator.
Frequently asked questions
What is the nursing diagnosis for anemia?
The most common is Excessive fatigue burden (00477), previously called Fatigue (00093). Decreased activity tolerance (00298) is also widely used.
What happened to the nursing diagnosis Fatigue?
In NANDA-I 2024-2026 it is called Excessive fatigue burden, code 00477.
Can anemia be the related factor?
No, it is the associated condition. Use something modifiable as the related factor, such as an imbalance between oxygen supply and demand during activity.
Other conditions
Study material: the diagnosis selection, sample statements and care plans were written by our editorial team using the NANDA-I 2024-2026 classification. They do not replace clinical judgment or your facility's protocols.
Classification sources: NANDA-I 2024-2026, Thieme supplement · Elsevier summary of changes. Reviewed November 2, 2026.