Iron deficiency anemia

Question 1

What is iron deficiency anemia and what causes it?

Answer 1

• Caused by inadequate supply of dietary iron
• Generally preventable
  
  • Iron-fortified cereals and formulas for infants
  • Special needs of premature infants
  • Adolescents at risk due to rapid growth and poor eating habits
• Most common in the U.S. (children 1 years old an adolescents)

Question 2

What is the pathophysiology behind iron deficiency anemia?

Answer 2

• Decreased supply of iron
• Impaired iron absorption
• Increased need for iron
• Synthesis of Hgb
• Infants
  
  • depletion of fetal iron stores at 5-6 months
  • excessive milk ingestion
  • fecal blood loss with ingestion of cow’s milk

Question 3

How would you diagnose iron deficiency anemia?

Answer 3

CBC, Reticulocyte Count, Peripheral Smear

RBC - normal, microcytic, hypochromic

Hgb ↓

Retic - normal or ↓

Hct ↓

Serum Iron Concen ↓

MCV ↓

TIBC - ­↑

Question 4

How would you manage children with iron deficiency anemia?

Answer 4

• Increase supplemental iron- nutrition counseling
• Iron fortified formula
• Less than 12 months of age- no cow’s milk
• Oral iron supplements- vitamin C increases absorption. Milk and milk products decrease absorption.
  
  • ​Give between meals!!
• Packed RBCs only for most severe anemia

Question 5

What are some nursing considerations for iron deficiency anemia?

Answer 5

• Absence of greenish black (this is a good sign if seen) stool may indicate poor administration of iron supplements.
• Administer iron supplements between meals, usually accompanied by citrus fruit or juice
• Liquid iron may stain teeth- brush after administration.
• Parenteral administration- z-track - because iron stains skin
• Parent nutrition education
  
  • Iron rich foods, red meat, beans, spinach, liver, beans,