NCLEX Review: Iron Deficiency Anemia

Overview

• Presenter: Sarah from RegisterNurseRN.com
• Topic: Iron Deficiency Anemia
• Series: Part of NCLEX review series on hematology

Key Points

• Iron Deficiency Anemia: Caused by low iron levels, leading to decreased red blood cells or hemoglobin.
• Anemia: Less oxygen is carried throughout the body, causing oxygen deprivation in tissues and organs.
• Most Common Anemia: Iron deficiency is the most common type of anemia.
• Role of Iron: Essential for making hemoglobin; low iron means fewer red blood cells and hemoglobin, leading to less oxygen.

Pathophysiology

• Red Blood Cells (RBCs): Transport oxygen and remove carbon dioxide with the help of hemoglobin.
• Hemoglobin: Protein in RBC that contains iron; 70% of body's iron is in hemoglobin.
• Low Iron Impact: Less hemoglobin and RBCs, leading to low oxygen levels.

Causes

1. Poor Intake

   • Pregnancy: Increased fetal demands for iron.
   • Poor diet: Malnutrition or vegetarian diet lacking iron-rich foods.

2. Absorption Issues

   • Intestinal surgery or gastric bypass.
   • Celiac disease or damage/removal of the small intestine.

3. Blood Loss

   • Heavy menstruation, GI bleeding, stomach ulcers, or hemorrhoids.

Signs and Symptoms (Mnemonic: LOW IRON)

• Lethargy: Fatigue from low oxygen.
• Overexerted: Easily tired, shortness of breath.
• Weird Food Cravings: Craving non-food items like ice or dirt.
• White Face: Pale appearance.
• Inflammation of Tongue (Glossitis): Smooth, red, and inflamed tongue.
• Increased Heart Rate: Tachycardia to compensate for low oxygen.
• Observations in Blood Smear: Hypochromic (pale) and microcytic (small) RBCs.
• Nail Changes: Spoon-shaped nails (koilonychia) and neuro changes (moodiness, concentration issues).

Nursing Interventions

• Monitoring: For bleeding, hemoglobin levels, and worsening symptoms.
• Education:
  • Iron supplements on an empty stomach or with vitamin C (e.g., orange juice).
  • Avoid taking with milk, calcium, or antacids (wait 2 hours).
  • Educate about normal dark stools with iron, not tarry stools.
  • Liquid iron: Use a straw, brush teeth to avoid staining.
  • Manage constipation: Increase fluids, consider stool softeners.
• Dietary Advice: Foods high in iron (Mnemonic: EAT LOTS OF IRON)
  • E: Egg yolks
  • A: Apricots
  • T: Tofu
  • L: Legumes, leafy greens (spinach)
  • O: Oysters, shellfish
  • T: Tuna
  • S: Sardines, seeds
  • O: Potatoes
  • F: Fish (halibut, haddock, salmon)
  • I: Iron-fortified cereals/breads
  • R: Red meats (beef), raisins
  • O: Poultry (chicken, turkey)
  • N: Nuts

Conclusion

• Call to Action: Visit RegisterNurseRN.com for quizzes and subscribe to the YouTube channel for more content.