Iron-deficiency Anemia
Definition: Iron deficiency anemia (IDA) is an ailment when there is not enough hemoglobin produced by the body to meet its requirement.
The benchmark for its diagnosis is marked by below-normal total body iron
Etiology:
- It is caused by inadequate intake of iron-rich foods or inadequate absorption of iron.
- Some of the known could be due to:
a.) chronic diarrhea
b.) malabsorption syndromes
c.) high cereal intake with low animal protein ingestion partial or complete gastrectomy
Prevalence: It is more common in developing countries and tropical zones. According to the Food and Nutrition Research Institute (FNRI) as of 2003, in the Philippines iron deficiency anemia is common among children 6 months to one year old, pregnant and lactating women. Government efforts are still being implemented since it poses a public concern. Women between 15 – 45 years old are the ones being mostly affected.
Pathophysiology: In IDA, when iron levels in the body decreases, transferrin which binds with and transport iron is also depleted. As a result, red blood cells (RBCs) the oxygen carrying component of the blood is likewise depleted leading to decreased levels of hemoglobin in the body.
Physical Findings:
- Asymptomatic if in mild cases
- palpitations, dizziness and cold sensitivity
- brittleness of hair, nails and pallor
- dysphagia, stomatis, atrophic glossitis
- dyspnea and weakness
Diagnosttic Examinations:
- Complete Blood count – first test to check the levels of the parts of the blood (red blood cells, white blood cells, platelets)
- Reticulocyte count – The test shows whether your bone marrow is making red blood cells at the correct rate.
- Peripheral smear – To check whether the red blood cells look (microcytic) smaller and (hypochromic) paler than normal
- Serum iron markedly decreased
- Serum ferritin decreased
*Ferritin – a protein that binds with iron in the body making it easier to be transported.
Medical Management:
- Oral supplements of iron (Ferrous Sulphate)
- Parenteral Iron – for children with iron malabsorption or chronic hemoglobinuria
- Transfusion – indicated for severe anemia cases of severe infection, cardiac dysfunction
Nursing Management:
- Asses for fatigue, activity intolerance, and other sings of impaired tissue oxygenation
- Promote an adequate intake of iron-rich foods (iron fortified formula and cereals, liver, egg yolk, and organ meats
- Emphasize to family members or care givers proper administration of oral iron supplements. Give supplements in two or three divided doses in small amount of Vitamin C-containing liquid. (This enhances absorption)
- Explain the potential adverse effects of iron which includes nausea and vomiting, diarrhea or constipation or black stools and tooth discoloration.
- Instruct care givers to keep iron supplements out of reach of children since it is toxic when overdosed.
image courtesy: catea.gatech.edu
Daisy Jane Antipuesto RN MN
Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.
