Planning the Nursing Care 

The goals of nursing care are: 

1.   Identify the causative factor of megaloblastic anaemia. 
2.   Administer appropriate vitamins depending  on the cause. 

Implementation of Nursing Care 

Identifying  the cause of anaemia is an important  activity. You as a nurse need to know wheather  the cause is due to deficiency of folic andor vitamin B1, otherwise this may lead to mismanagement of the case. Once the cause is identified, its recurrence needs to be avoided, drugs responsible  for producing  this  anaemia  should be stopped. Child with folic acid deficiency is given iron in the dose of 5 mg per day orally or parenterally together with 200 mg per day of oral ascorbic acid and is continued for two to three weeks. 

In case of vitamin B₁₂  deficiency it is given 15 to 30 meg in young children and 100 mcg in older children in the  form of  cyanocoblamine  hydroxycobalamine, intrarnusculary  thrice  a week until hemoglobin is normal. This  is followed by 100 mcg intramuscularly once a month. 

During  drug  therapy child should be monitored for any neurological symptoms  and tremors  as patients of B,, deficiency if treated initially with folic acid may present with these symptoms.