One of the major signs of anaemia in children is :

IGNOU PB Bsc Nsg.Entrance-2026

Child Health Nursing (Pediatrics)

Medium

Appeared in: IGNOU PB Bsc Nsg.Entrance-2026

Explanation

Anemia leads to a compensatory increase in cardiac output, creating a 'high output' or hyperdynamic circulatory state to maintain oxygen delivery to tissues.
This increased blood flow velocity, combined with the lower viscosity ('thinner' blood) of anemia, causes turbulent flow through the heart's valves.
This turbulence is heard during auscultation as a functional, mid-systolic 'flow' murmur, also known as a hemic murmur.
Because it is a direct physical consequence of the body's primary compensation for anemia, it is considered a major and very common sign in children.

Option A: While tachycardia (rapid heart beat) is a compensatory mechanism for anemia, it is more characteristic of acute or severe anemia. In chronic, well-compensated anemia, a child's heart rate may be normal or only slightly elevated at rest.
Option B: Shortness of breath (dyspnea) is a symptom of significant anemia, particularly on exertion, when the body's oxygen demand outstrips the supply. It is not as consistent a finding as a murmur, especially in mild or moderate cases.
Option C: Dizziness is a symptom of cerebral hypoxia (inadequate oxygen to the brain). It typically occurs only in cases of severe or rapidly developing anemia and is not considered a primary or common sign in most pediatric anemia cases.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Cardiovascular manifestations of pediatric anemia as background academic context rather than a clinical decision trigger.
Auscultation of the heart is a fundamental nursing assessment skill. Identifying a new murmur can be the first clue to an underlying systemic condition like anemia.
Nurses must be able to differentiate between a functional murmur (like one from anemia, which resolves with treatment) and a pathologic murmur from a structural heart defect, which requires cardiology referral.
What if? A child with known iron-deficiency anemia presents with a murmur and also has a fever. The fever can also cause a flow murmur due to increased cardiac output. The nurse should document both findings and reassess the murmur after the fever resolves to see if it changes in character.

How to Approach the Question

First, identify the core concept: 'major signs' of anemia in children. This asks for a characteristic and common finding.
Recall the pathophysiology of anemia: the body's main compensation is to increase cardiac output (pump blood faster) to make up for the blood's poor oxygen content.
Analyze each option in the context of this compensation. A rapid heartbeat, shortness of breath, and dizziness are all possible effects, but how consistent are they?
A cardiac murmur in this context is a direct physical sign caused by the high-flow, low-viscosity state. It's a 'hemic murmur'.
Compare the options. The murmur is a direct result of the hyperdynamic state itself, whereas the other symptoms often depend on the severity or acuity of the anemia.
Conclude that the cardiac murmur is the most direct and characteristic physical sign among the choices.

Concept Tested & Keywords

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E6 Ghai Essential Pediatrics(pp 26-904 of 913) pp. 351-353, 432-434