NCLEX Review: Iron Deficiency Anemia

Introduction

• Presenter: Sarah from RegisteredNurseRN.com
• Part of the NCLEX review series on hematology
• Focus areas:
  • Definition of iron deficiency anemia
  • Pathophysiology
  • Causes
  • Signs and symptoms
  • Nursing interventions
  • Mnemonics for memory aids

Definition

• Iron Deficiency Anemia: A type of anemia caused by low iron levels.
  • Anemia: Decreased red blood cells or hemoglobin leading to reduced oxygen transport in the body.
• Most common type of anemia.

Key Points

• Body uses iron to produce hemoglobin.
• Low iron levels → fewer red blood cells → less hemoglobin → reduced oxygen.
• Early signs are vague (e.g., fatigue).
• Diagnosis: CBC (Complete Blood Count), iron level check, or blood smear.
• Treatment: Dietary changes, iron supplementation, prevention strategies.

Pathophysiology

• Red Blood Cell (RBC): Transports oxygen and removes CO2.
• Hemoglobin: Protein in RBCs that contains iron, crucial for oxygen transport.
• 70% of body iron is in hemoglobin.
• Low iron → low hemoglobin and RBCs → low oxygen levels.

Causes of Iron Deficiency Anemia

1. Poor Intake
   • Pregnancy: Increased iron demand.
   • Poor diet or malnourishment.
   • Vegetarian diet lacking in iron-rich foods.
2. Absorption Problems
   • Intestinal surgery or gastric bypass.
   • Celiac disease or small intestine issues.
3. Blood Loss
   • Heavy menstruation.
   • GI bleeding (e.g., ulcers, hemorrhoids).

Signs and Symptoms

• Mnemonic: LOW IRON:
  • L: Lethargic (fatigue due to low oxygen).
  • O: Overexerted easily (shortness of breath).
  • W: Weird food cravings (e.g., ice, clay).
  • W: White face (pale appearance).
  • I: Inflammation of the tongue (glossitis).
  • I: Increased heart rate (tachycardia).
  • R: Reduced hemoglobin level.
  • O: Observe changes in RBCs (hypochromic and microcytic).
  • N: Nail changes (spoon shape, neuro changes).

Nursing Interventions

• Monitoring: Bleeding, hemoglobin, hematocrit, major signs, and symptoms.
• Education:
  • Iron supplements on an empty stomach, possibly with vitamin C.
  • Avoid taking with milk, calcium, or antacids.
  • Explain the normal stool color changes (dark black).
  • Liquid iron: Use a straw and brush teeth to prevent staining.
  • Side effects: Address constipation with liquids or stool softeners.
• Treatment: Possible IV iron or blood transfusion.

Dietary Recommendations

• Mnemonic: EAT LOTS OF IRON:
  • E: Egg yolks
  • A: Apricots
  • T: Tofu
  • L: Legumes, leafy greens like spinach
  • O: Oysters, other shellfish
  • T: Tuna
  • S: Sardines, seeds
  • O: Potatoes
  • F: Fish (halibut, haddock, salmon)
  • I: Iron-fortified cereals or breads
  • R: Red meat (beef) or raisins
  • O: Poultry (chicken, turkey)
  • N: Nuts

Conclusion

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