Iron Deficiency Anemia

Question 1

What causes iron deficiency anemia?

Answer 1

Insufficient iron available for erythropoiesis resulting in anemia.

Question 2

What is the most common type of anemia throughout the world?

Answer 2

Iron deficiency anemia

Question 3

Etiology of IDA

Answer 3

• 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

Question 4

Etiology for IDA that is common in females

Answer 4

Menorrhagia

Question 5

Etiology for IDA that is common in males

Answer 5

Ulcers, hemorrhoids, cancer

Question 6

How can pregnancy cause IDA?

Answer 6

D/t high requirement of iron because of the fetus

Question 7

IDA is common in

Answer 7

Adolescents, children (<2 y.o.)

Question 8

Iron

Answer 8

Is in constant use in the body and can be “recycled”

Question 9

Iron is stored in the form of

Answer 9

Hemoglobin

Question 10

IDA develops

Answer 10

Slowly and overlapping 3 stages

Question 11

Iron Deficiency Anemia: Stage I

Answer 11

Body’s iron stores for red cell production and hemoglobin synthesis are depleted.

Question 12

Iron Deficiency Anemia: Stage II

Answer 12

Insufficient amounts of iron are transported to the marrow and THEN iron deficient red cells are produced (impaired erythropoiesis)

Question 13

Iron Deficiency Anemia: Stage III

Answer 13

Insufficient iron supply & diminished HGB synthesis (clinical manifestations appear in this stage)

Question 14

Normal Plasma Ferritin

Answer 14

60

Question 15

Normal Transferrin Saturation (%)

Answer 15

35

Question 16

Normal RBC Protoporphyrin

Answer 16

30

Question 17

Normal Hemoglobin (g/dl)

Answer 17

> 12

Question 18

In iron depletion

Answer 18

Plasma ferritin = <12

Transferrin Saturation, hemoglobin and RBC Protoporphyrin are normal

Question 19

In Iron Deficient Erythropoiesis

Answer 19

Plasma Feritin = <12
Transferrin Saturation = <16
RBC Protoporphyrin = >100
Hemoglobin is normal

Question 20

In Iron Deficiency Anemia

Answer 20

Plasma Ferritin = <12
Transferrin Saturation = <16
RBC Protoporphyrin = >100
Hemoglobin = <12

Question 21

Clinical Manifestations of IDA

Answer 21

Fatigue 
Drowsiness*
Weakness
SOB
Pallor
Headaches (frequent)
Irritability 
Neuromuscular changes including memory problems
Lethargy
Some Pts have reported extremity numbness

Question 22

IDA has a

Answer 22

Gradual onset, seek help usually when hemoglobin drops <7 or 8g/dl

Question 23

Clinical Manifestations for severe cases of IDA

Answer 23

Koilonychia
Stomatitis
Gloss it’s

Question 24

Koilonychia

Answer 24

Brittle, spoon shaped nails

Question 25

Stomatitis

Answer 25

Sores in corners of mouth

Question 26

Glossitis

Answer 26

Tongue atrophy, soreness, redness, burning

Question 27

How would you evaluate for IDA?

Answer 27

``` 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 ```

Question 28

Treatments for Iron deficiency anemia

Answer 28

- 1st step: identify and treat the root cause | - Iron replacement: oral replacement initial treatment

Question 29

If severe, what treatment might be used to treat iron deficiency anemia?

Answer 29

Might need IV iron replacement

Question 30

Mechanism of Action: Iron

Answer 30

O2 carrier in hemoglobin and myoglobin Crucial for tissue respiration Corrects IDA symptoms

Question 31

Indications for Iron

Answer 31

Treatment and prevention of IDA

Question 32

Contraindications

Answer 32

Allergy, hemochromatosis, hemolytic anemia and other anemias not associated with IDA

Question 33

Adverse Effects of Iron

Answer 33

Mostly GI (pp. 864-865, lilley) N/V, constipation, sometimes diarrhea, abdominal pain Dark, tarry stools Discoloration of tooth enamel

Question 34

What should you watch for when giving a patient iron?

Answer 34

Watch for iron toxicity

Question 35

Interactions and Dosages of Iron

Answer 35

Selected drugs and dosages, refer to pp. 864-866

Question 36

Nursing Process & Patient-Centered Care

Answer 36

Pp. 867-869

Question 37

Iron is best absorbed w/

Answer 37

Vitamin C (i.e orange juice)

Question 38

Iron has reduced absorption w/

Answer 38

Calcium and antacids

Question 39

Potential nursing diagnosis for IDA

Answer 39

Fatigue (activity intolerance) Constipation Imbalanced nutrition