Understanding Iron Deficiency Anemia

Hey everyone, it's Sarah with RegisteredNurseRN.com and in this video I'm going to be doing an NCLEX review over iron deficiency anemia. This video is part of an NCLEX review series over hematology. So what I'm going to be doing in this video is I'm going to be covering what iron deficiency anemia is, the patho, the causes, the signs and symptoms, and the nursing interventions, and giving you some mnemonics on how to remember some of this material. So let's get started. First, let's start out talking about what is the definition of iron deficiency anemia. This is a type of anemia that is caused by low iron levels. So the big thing with this is that we have anemia going on because we don't have enough iron in the body. But what is anemia? Anemia is the decreased amount of red blood cells or hemoglobin in the body and these components play a huge role in carrying oxygen throughout your body. So if you do not have enough of this you are going to be experiencing your tissues and organs are going to be deprived of oxygen and later on depending on how severe this is you'll start showing signs and symptoms of it. So before we dive into the patho let's talk about the key points we need to remember about this disease that's going on. Okay this iron deficiency anemia is the most common type of anemia. There's various forms which I will be covering but this is the most common type. The body uses iron to make hemoglobin so without iron you don't you won't have enough hemoglobin and low iron Iron levels lead the body to produce fewer red blood cells which leads to less hemoglobin and hence your body will receive less oxygen. Which here in a second you're going to see why, the reasoning behind this in the patho part. Now, at first the signs and symptoms of iron deficiency anemia are vague. The patient probably won't know what's going on. They may just feel a little fatigued but as it gets worse and worse because they're not treating it. It will progress where they become more noticeable. And iron deficiency anemia is usually diagnosed, the patient will go in, talk about this. The doctor may order a CBC, a complete blood count, which they'll look at the red blood cells, and the hemoglobin level, hematocrit levels, see if those are normal. I may order an iron level, because remember iron plays a huge role in making hemoglobin. Or they may do a blood smear test, where they will take and look under. a microscope at the red blood cells and look at their appearance because they will have a specific appearance in iron deficiency anemia. Treatment for this condition will be diet changes and putting more iron in the diet in iron rich foods, iron supplementation with medication, and how to prevent this. Now let's talk about the patho. What is going on in the body? Here we have a red blood cell. Our key player here is our red blood cell. The red blood cell's role is it acts as the car. It functions to transport oxygen and remove carbon dioxide from the body with the help of hemoglobin. Big part. Hemoglobin, which you will see in here, is an ingredient that is found in the red blood cell that is a protein that contains iron. Hemoglobin and iron love each other. In iron, your iron store, 70% of your iron is actually found in your hemoglobin. So iron makes hemoglobin. So you need iron to make hemoglobin. Hence, to play the whole role in transporting oxygen throughout the body. Because if you don't have enough of this, the red blood cell, even though it'll be going around doing its job, if you don't have the hemoglobin on board to do its job, it can't carry the oxygen and transport it throughout the body. So they go hand in hand. So the hemoglobin... function in a nutshell is to facilitate the transfer of oxygen and carbon dioxide. So with iron deficiency anemia, when you have low iron, you will have less hemoglobin, less red blood cells. In turn, you will have less oxygen in the body and your body does not like low oxygen levels. Okay. So what causes iron deficiency anemia? Three big things. Easy to remember. Okay. Number one, poor intake. What can this be? be from one pregnancy as the mother goes through as she gets up to nine months the fetal demands for iron is great and if she's not taking it in through her diaries taking prenatal vitamins she can experience this or a poor diet overall patients not eating malnourished they can have this or someone who follows a vegetarian diet they need Make sure that they're incorporating foods that have iron in them because they are susceptible to this. Second cause is an absorption problem. Your intestines, your gut, plays a huge role in absorbing iron. So if you've had intestines, surgery, gastric bypass, you're at risk for this, celiac disease because you have damage to the intestines and you won't be absorbing as much iron as you need. Also the small intestine, say you had it removed. The small intestine plays a huge role in absorbing iron. So any issues with small intestine, you can have iron deficiency anemia. And then the last thing, which is the most obvious, losing iron from blood loss. Any type of extreme blood loss can cause this. For women who have heavy menstruation, they are definitely at risk for this. They're losing a lot of blood. GI bleeding, ulcers in the stomach, or hemorrhoids. They can also develop this. Okay, so what are the major signs and symptoms that you need to know for NCLEX or your nursing lecture exams for iron deficiency anemia? To help you remember the signs and symptoms, remember the mnemonic low iron, because that is the whole deal with this disease is that they have really low iron levels. Okay, so L, they are going to be lethargic. This plays back to. They have low oxygen being transported through the body because the red blood cells and hemoglobin can't do their job of transporting it where it needs to go. So they'll be tired. O, they're going to be overexerted easily, again, because of the low oxygen. They may have shortness of breath. Walking back and forth up a hill that they normally could walk up, all of a sudden it's a lot harder for them. They need to sit down and rest and they get short of breath. That's just, again, because you're restatory. system, we did a whole NCLEX review on respiratory, plays a huge role in delivering oxygen and your red blood cells are in those alveolar sacs collecting the oxygen. And if your red blood cells aren't there to collect the oxygen you're breathing in, then it's no good and you're not transporting the oxygen where you need to get. Next, W for weird food cravings. Some, even your pregnant patients, if a patient reports that they're craving like ice continually or clay or dirt, that could be a sign. that the body is low on iron. Another thing, W for white face, meaning pale. They'll have this pale pallor look to them because of the low oxygen. Next, I, inflammation of the tongue, also known as glossitis. This is where the tongue will, instead of being textured, it'll have a smooth appearance. It'll be red and inflamed, maybe various shades of red. And this is due to the decreased oxygen that the tongue is receiving. Because remember, we have issues. with having enough oxygen transported in our body. Another I would be increased heart rate. The heart rate increases, becomes tachycardic because the body is trying to compensate for the low oxygen levels by pumping faster, getting that to the body. R for reduced hemoglobin level. O for you'll be able to observe changes in the red blood cells if a blood smear was done. I would remember this. So whenever they go get a blood smear, they had iron deficiency, anemia, what would those red blood cells look like? Okay. They would be hypochromic, meaning they would be pale. They would have a pale look to them. And microcytic, this is where they would be small. So they're going to be really pale and really small compared to having nice color to them and being normal size. Next, in for nail changes. The nails can change in appearance depending on how long they've had this. the severity of it and they can turn and have a spoon shape to them and the medical term for this is coleonicia. Another change they can have are neuro changes and this is where they will have the inability to concentrate, they'll be moody and not feel like they normally do. Now to nursing interventions. Nursing interventions include what you're going to do as a nurse is you're going to monitor them, you're going to educate them and you're going to administer meds. What you'll be monitoring for is any bleeding, hemoglobin, hematocrit levels, and major signs and symptoms we just went over. Also educate them on how to take their iron supplements. A lot of times patients will be prescribed iron. There are some things you want to remember as a nurse when providing education to them. They want to take the iron on an empty stomach. stomach. This increases absorption. Sometimes iron can upset the stomach so they can maybe eat a small amount of food with it to prevent those GI upsets. It's best to take it on an empty stomach. Take it with vitamin C like orange juice because vitamin C increases absorption of iron. Next, they do not want to take iron along with any milk products, calcium or antacids. If they have to take this stuff, they need to wait two hours in between before they take the iron and then they take the calcium antacid or whatever they need to take because that decreases absorption. absorption. Let the patient know that whenever they have a bowel movement that their stool is normal for it to look dark black. That means that the body is actually absorbing the iron. It's not normal to have dark, tarry stools or any blood in it. That's not normal. A dark colored stool is normal whenever taken iron. Liquid preparations, it's best to mix it in a drink and drink it through a straw because it can stain the teeth and to brush the teeth afterwards to prevent it. from staining the teeth. Side effects of iron is constipation. So educate your patient, make sure they're consuming lots of liquids. And if they need to, they can get an over-the-counter stool softener like Colace, help soften the stool, prevent constipation. Also as the nurse, depending on how low their iron level is, you may give it IV or if the hemoglobin hematocrit is really low, you may be giving blood. Also, you'll want to educate your patients on how to incorporate iron in. their diet because a lot of nursing lecture exams or NCLEX on the NCLEX that may give you a scenario and ask you which foods are best for a patient to eat who has iron deficiency anemia so help so to help you remember which foods are high in iron remember the mnemonic eat lots of iron and each letter will correspond with a food so E for egg yolks A for apricots T for tofu L for legumes also leafy green vetch like spinach. O for oysters, any shellfish is good. T for tuna, S for sardines and seeds, and then the O in potatoes. F for fish like halibut, haddock, or salmon. I for iron-fortified cereal or breads. R for red meats like beef, very rich in iron or raisins, and then O in the word poultry, any chicken, turkey, that is rich in iron. And then the last one, N for nuts. Okay, so thank you so much for watching. That was about iron deficiency anemia. And be sure to go to my website, registernurseRN.com, and take that free quiz. And don't forget to subscribe to this YouTube channel.

So let's get started. First, let's start out talking about what is the definition of iron deficiency anemia. This is a type of anemia that is caused by low iron levels. So the big thing with this is that we have anemia going on because we don't have enough iron in the body. But what is anemia?

Anemia is the decreased amount of red blood cells or hemoglobin in the body and these components play a huge role in carrying oxygen throughout your body. So if you do not have enough of this you are going to be experiencing your tissues and organs are going to be deprived of oxygen and later on depending on how severe this is you'll start showing signs and symptoms of it. So before we dive into the patho let's talk about the key points we need to remember about this disease that's going on. Okay this iron deficiency anemia is the most common type of anemia.

There's various forms which I will be covering but this is the most common type. The body uses iron to make hemoglobin so without iron you don't you won't have enough hemoglobin and low iron Iron levels lead the body to produce fewer red blood cells which leads to less hemoglobin and hence your body will receive less oxygen. Which here in a second you're going to see why, the reasoning behind this in the patho part. Now, at first the signs and symptoms of iron deficiency anemia are vague. The patient probably won't know what's going on.

They may just feel a little fatigued but as it gets worse and worse because they're not treating it. It will progress where they become more noticeable. And iron deficiency anemia is usually diagnosed, the patient will go in, talk about this.

The doctor may order a CBC, a complete blood count, which they'll look at the red blood cells, and the hemoglobin level, hematocrit levels, see if those are normal. I may order an iron level, because remember iron plays a huge role in making hemoglobin. Or they may do a blood smear test, where they will take and look under. a microscope at the red blood cells and look at their appearance because they will have a specific appearance in iron deficiency anemia.

Treatment for this condition will be diet changes and putting more iron in the diet in iron rich foods, iron supplementation with medication, and how to prevent this. Now let's talk about the patho. What is going on in the body? Here we have a red blood cell.

Our key player here is our red blood cell. The red blood cell's role is it acts as the car. It functions to transport oxygen and remove carbon dioxide from the body with the help of hemoglobin. Big part.

Hemoglobin, which you will see in here, is an ingredient that is found in the red blood cell that is a protein that contains iron. Hemoglobin and iron love each other. In iron, your iron store, 70% of your iron is actually found in your hemoglobin. So iron makes hemoglobin.

So you need iron to make hemoglobin. Hence, to play the whole role in transporting oxygen throughout the body. Because if you don't have enough of this, the red blood cell, even though it'll be going around doing its job, if you don't have the hemoglobin on board to do its job, it can't carry the oxygen and transport it throughout the body.

So they go hand in hand. So the hemoglobin... function in a nutshell is to facilitate the transfer of oxygen and carbon dioxide. So with iron deficiency anemia, when you have low iron, you will have less hemoglobin, less red blood cells.

In turn, you will have less oxygen in the body and your body does not like low oxygen levels. Okay. So what causes iron deficiency anemia?

Three big things. Easy to remember. Okay. Number one, poor intake.

What can this be? be from one pregnancy as the mother goes through as she gets up to nine months the fetal demands for iron is great and if she's not taking it in through her diaries taking prenatal vitamins she can experience this or a poor diet overall patients not eating malnourished they can have this or someone who follows a vegetarian diet they need Make sure that they're incorporating foods that have iron in them because they are susceptible to this. Second cause is an absorption problem.

Your intestines, your gut, plays a huge role in absorbing iron. So if you've had intestines, surgery, gastric bypass, you're at risk for this, celiac disease because you have damage to the intestines and you won't be absorbing as much iron as you need. Also the small intestine, say you had it removed.

The small intestine plays a huge role in absorbing iron. So any issues with small intestine, you can have iron deficiency anemia. And then the last thing, which is the most obvious, losing iron from blood loss.

Any type of extreme blood loss can cause this. For women who have heavy menstruation, they are definitely at risk for this. They're losing a lot of blood. GI bleeding, ulcers in the stomach, or hemorrhoids. They can also develop this.

Okay, so what are the major signs and symptoms that you need to know for NCLEX or your nursing lecture exams for iron deficiency anemia? To help you remember the signs and symptoms, remember the mnemonic low iron, because that is the whole deal with this disease is that they have really low iron levels. Okay, so L, they are going to be lethargic. This plays back to. They have low oxygen being transported through the body because the red blood cells and hemoglobin can't do their job of transporting it where it needs to go.

So they'll be tired. O, they're going to be overexerted easily, again, because of the low oxygen. They may have shortness of breath. Walking back and forth up a hill that they normally could walk up, all of a sudden it's a lot harder for them. They need to sit down and rest and they get short of breath.

That's just, again, because you're restatory. system, we did a whole NCLEX review on respiratory, plays a huge role in delivering oxygen and your red blood cells are in those alveolar sacs collecting the oxygen. And if your red blood cells aren't there to collect the oxygen you're breathing in, then it's no good and you're not transporting the oxygen where you need to get. Next, W for weird food cravings.

Some, even your pregnant patients, if a patient reports that they're craving like ice continually or clay or dirt, that could be a sign. that the body is low on iron. Another thing, W for white face, meaning pale.

They'll have this pale pallor look to them because of the low oxygen. Next, I, inflammation of the tongue, also known as glossitis. This is where the tongue will, instead of being textured, it'll have a smooth appearance.

It'll be red and inflamed, maybe various shades of red. And this is due to the decreased oxygen that the tongue is receiving. Because remember, we have issues. with having enough oxygen transported in our body. Another I would be increased heart rate.

The heart rate increases, becomes tachycardic because the body is trying to compensate for the low oxygen levels by pumping faster, getting that to the body. R for reduced hemoglobin level. O for you'll be able to observe changes in the red blood cells if a blood smear was done. I would remember this. So whenever they go get a blood smear, they had iron deficiency, anemia, what would those red blood cells look like?

Okay. They would be hypochromic, meaning they would be pale. They would have a pale look to them.

And microcytic, this is where they would be small. So they're going to be really pale and really small compared to having nice color to them and being normal size. Next, in for nail changes.

The nails can change in appearance depending on how long they've had this. the severity of it and they can turn and have a spoon shape to them and the medical term for this is coleonicia. Another change they can have are neuro changes and this is where they will have the inability to concentrate, they'll be moody and not feel like they normally do. Now to nursing interventions.

Nursing interventions include what you're going to do as a nurse is you're going to monitor them, you're going to educate them and you're going to administer meds. What you'll be monitoring for is any bleeding, hemoglobin, hematocrit levels, and major signs and symptoms we just went over. Also educate them on how to take their iron supplements. A lot of times patients will be prescribed iron.

There are some things you want to remember as a nurse when providing education to them. They want to take the iron on an empty stomach. stomach. This increases absorption.

Sometimes iron can upset the stomach so they can maybe eat a small amount of food with it to prevent those GI upsets. It's best to take it on an empty stomach. Take it with vitamin C like orange juice because vitamin C increases absorption of iron. Next, they do not want to take iron along with any milk products, calcium or antacids.

If they have to take this stuff, they need to wait two hours in between before they take the iron and then they take the calcium antacid or whatever they need to take because that decreases absorption. absorption. Let the patient know that whenever they have a bowel movement that their stool is normal for it to look dark black. That means that the body is actually absorbing the iron.

It's not normal to have dark, tarry stools or any blood in it. That's not normal. A dark colored stool is normal whenever taken iron.

Liquid preparations, it's best to mix it in a drink and drink it through a straw because it can stain the teeth and to brush the teeth afterwards to prevent it. from staining the teeth. Side effects of iron is constipation. So educate your patient, make sure they're consuming lots of liquids.

And if they need to, they can get an over-the-counter stool softener like Colace, help soften the stool, prevent constipation. Also as the nurse, depending on how low their iron level is, you may give it IV or if the hemoglobin hematocrit is really low, you may be giving blood. Also, you'll want to educate your patients on how to incorporate iron in. their diet because a lot of nursing lecture exams or NCLEX on the NCLEX that may give you a scenario and ask you which foods are best for a patient to eat who has iron deficiency anemia so help so to help you remember which foods are high in iron remember the mnemonic eat lots of iron and each letter will correspond with a food so E for egg yolks A for apricots T for tofu L for legumes also leafy green vetch like spinach. O for oysters, any shellfish is good.

T for tuna, S for sardines and seeds, and then the O in potatoes. F for fish like halibut, haddock, or salmon. I for iron-fortified cereal or breads.

R for red meats like beef, very rich in iron or raisins, and then O in the word poultry, any chicken, turkey, that is rich in iron. And then the last one, N for nuts. Okay, so thank you so much for watching.

That was about iron deficiency anemia. And be sure to go to my website, registernurseRN.com, and take that free quiz. And don't forget to subscribe to this YouTube channel.

Transcript for:Understanding Iron Deficiency Anemia

Transcript for:
Understanding Iron Deficiency Anemia