Iron deficiency Anemia

1. ANEMIAS

2. ANEMIAS
Anemia is the lack of sufficient circulating
hemoglobin to deliver oxygen to tissues Anemia has
multiple causes and is com- monly associated with
other diseases and disorders (eg, renal disease,
cancer, Crohn's disease, alcoholism). Anemia may be
caused by inadequate production of RBCs, abnormal
hemoly- sis and sequestration of RBCs, or blood
loss) Iron-deficiency anemia, pernicious anemia,
folic acid-deficiency anemia, and aplastic anemia are
the anemias most commonly seen in adults.

3. Iron-Deficiency Anemia
(Microcytic,
Hypochromic)
Iron-deficiency anemia is a condition in which the total body iron
content is decreased below a normal level, affecting hemoglobin
synthesis. RBCs appear pale and are small.

4. 1. The most common cause is chronic blood loss (GI bleed- ing
including occult colorectal cancers, excessive menstrual
bleeding, hookworm infestation), but anemia may also be
caused by insufficient intake of iron (weight loss, inadequate
diet), iron malabsorption (end-stage renal disease, small-
bowel disease, gastroenterostomy), or increased requirements
(pregnancy, periods of rapid growth).
2. Decreased hemoglobin may result in insufficient oxygen
delivery to body tissues.
Etiology

5. 3. The incidence of iron-deficiency anemia, the
most common type of anemia, varies widely by
age, sex, and race. In the United States, it is
more than twice as common in women as
compared to men, affecting 10% of non-
Hispanic white women and 20% of black and
Hispanic women. It is a major health problem in
developing countries.
4. Symptoms generally develop when
hemoglobin has fallen to less than 11 g/100
mL.

6. PATHOPHYSIOLOG
Y

7. Chronic blood loss,Insufficient iron
intake,Iron malabsorption,Increased iron
requirements.
Decreased hemoglobin
Insufficient oxygen delivery to body tissues

8. Clinical Manifestations
1. Headache, dizziness, fatigue, tinnitus.
2. Palpitations, dyspnea on exertion, pallor of
skin and mucous membranes.
3. In developing world: smooth, sore tongue;
cheilosis (lesions at corners of mouth),
koilonychia (spoon-shaped fingernails), and pica
(craving to eat unusual substances).

9. Diagnostic Evaluation
1. CBC and iron profile-decreased hemoglobin,
hemato- crit, serum iron, and ferritin; elevated red
cell distribution width and normal or elevated total
iron-binding capacity (transferrin).
2. Determination of source of chronic blood loss
may include sigmoidoscopy, colonoscopy, upper
and lower GI studies, stools and urine for occult
blood examination.

10. Management
1. Diagnosis and correction of chronic blood loss.
2. Oral or parenteral iron therapy.
a. Oral ferrous sulfate preferred and least
expensive; treat- ment continues until hemoglobin
level is normalized and iron stores replaced (up to 6
months).
b. Parenteral therapy may be used when patient
cannot tolerate or is noncompliant with oral therapy.
May use sodium ferric gluconate, iron sucrose, or
iron dextran.

11. Nursing Assessment
1. Obtain history of symptoms, dietary intake, past history of anemia, possible
sources of blood loss.
2. Examine for tachycardia, pallor, dyspnea, and signs of GI or other bleeding.
Nursing Diagnosis
Imbalanced Nutrition: Less Than Body Requirements related to inadequate intake of
iron.
Activity Intolerance related to decreased oxygen-carrying capacity of the blood.
Ineffective Tissue Perfusion related to decreased oxygen- carrying capacity of the
blood.

12. Patient Education and Health Maintenance
1. Educate patient on proper nutrition and good sources of
iron: (see Table 32-3). The daily requirement of iron for adult
females age 19 to 50 is 18 mg, for men 8 mg; however, more is
needed to build iron stores in those who have been anemic
and for those who are at risk for anemia.
2. Teach patient about iron supplementation.
a. Take iron on empty stomach, with full glass of water or fruit
juice.
b. Liquid forms may stain teeth; mix well with water or fruit juice
and use a straw.

13. c. Anticipate some epigastric discomfort, change in color of
stools to green or black, and, in some cases, nausea, con-
stipation, or diarrhea. Prevent and treat constipation with
increased fibre, fluid and exercise.

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