Iron Deficiency Anemia Flashcards
What causes iron deficiency anemia?
Insufficient iron available for erythropoiesis resulting in anemia.
What is the most common type of anemia throughout the world?
Iron deficiency anemia
Etiology of IDA
- Chronic blood loss (i.e Chron’s disease, etc.)
- Inadequate dietary intake of iron
- Medications: GI meds, NSAIDs..
- Surgical Procedures (any procedure that predisposes the patient to bleeding)
- Medical Conditions (i.e ulcerative colitis, kidney failure)
- Eating disorders (pica)
- Pregnancy
- Blood donation
Etiology for IDA that is common in females
Menorrhagia
Etiology for IDA that is common in males
Ulcers, hemorrhoids, cancer
How can pregnancy cause IDA?
D/t high requirement of iron because of the fetus
IDA is common in
Adolescents, children (<2 y.o.)
Iron
Is in constant use in the body and can be “recycled”
Iron is stored in the form of
Hemoglobin
IDA develops
Slowly and overlapping 3 stages
Iron Deficiency Anemia: Stage I
Body’s iron stores for red cell production and hemoglobin synthesis are depleted.
Iron Deficiency Anemia: Stage II
Insufficient amounts of iron are transported to the marrow and THEN iron deficient red cells are produced (impaired erythropoiesis)
Iron Deficiency Anemia: Stage III
Insufficient iron supply & diminished HGB synthesis (clinical manifestations appear in this stage)
Normal Plasma Ferritin
60
Normal Transferrin Saturation (%)
35
Normal RBC Protoporphyrin
30
Normal Hemoglobin (g/dl)
> 12
In iron depletion
Plasma ferritin = <12
Transferrin Saturation, hemoglobin and RBC Protoporphyrin are normal
In Iron Deficient Erythropoiesis
Plasma Feritin = <12
Transferrin Saturation = <16
RBC Protoporphyrin = >100
Hemoglobin is normal
In Iron Deficiency Anemia
Plasma Ferritin = <12
Transferrin Saturation = <16
RBC Protoporphyrin = >100
Hemoglobin = <12
Clinical Manifestations of IDA
Fatigue Drowsiness* Weakness SOB Pallor Headaches (frequent) Irritability Neuromuscular changes including memory problems Lethargy Some Pts have reported extremity numbness
IDA has a
Gradual onset, seek help usually when hemoglobin drops <7 or 8g/dl
Clinical Manifestations for severe cases of IDA
Koilonychia
Stomatitis
Gloss it’s
Koilonychia
Brittle, spoon shaped nails
Stomatitis
Sores in corners of mouth
Glossitis
Tongue atrophy, soreness, redness, burning
How would you evaluate for IDA?
CBC (hemoglobin and hematocrit) Ferritin level: if it's low - indication of iron deficiency anemia (diagnostic for iron deficiency anemia) Transferrin saturation TIBC (total iron binding capacity) Stool for occult blood
Treatments for Iron deficiency anemia
- 1st step: identify and treat the root cause
- Iron replacement: oral replacement initial treatment
If severe, what treatment might be used to treat iron deficiency anemia?
Might need IV iron replacement
Mechanism of Action: Iron
O2 carrier in hemoglobin and myoglobin
Crucial for tissue respiration
Corrects IDA symptoms
Indications for Iron
Treatment and prevention of IDA
Contraindications
Allergy, hemochromatosis, hemolytic anemia and other anemias not associated with IDA
Adverse Effects of Iron
Mostly GI (pp. 864-865, lilley)
N/V, constipation, sometimes diarrhea, abdominal pain
Dark, tarry stools
Discoloration of tooth enamel
What should you watch for when giving a patient iron?
Watch for iron toxicity
Interactions and Dosages of Iron
Selected drugs and dosages, refer to pp. 864-866
Nursing Process & Patient-Centered Care
Pp. 867-869
Iron is best absorbed w/
Vitamin C (i.e orange juice)
Iron has reduced absorption w/
Calcium and antacids
Potential nursing diagnosis for IDA
Fatigue (activity intolerance)
Constipation
Imbalanced nutrition
