Disorder Etiology Pathogenesis Clinical Diagnostic Medical/ Surgical Nursing Management

Manifestations Test Interventions

Iron Deficiency Decreased iron • depletion of storage -Anemia -Bone marrow -Stool specimen should be -Health history must be obtained for
Anemia absorption can iron -Smooth sore tongue aspiration (To tested for occult blood multiple pregnancies, GI bleeding, and
result from o both ferritin -Brittle and ridged detect iron which -Periodic colonoscopy, pica
gastrectomy and and hemosiderin act as nails is at low level or endoscopy, x-ray examination of -Nutritional counseling can be provided
upper small-bowel iron storage compon- -Angular cheilosis absent) GI tract to detect ulcerations, for those whose usual diet is
malabsorption ents with serum ferritin (Ulceration of the gastritis, polyps or cancer inadequate
syndromes. Rarely, providing a relatively corner of the mouth) Low serum Medications: -Encourage patient to continue iron
absorption is accurate estimate of -Craving of ice, ferritin levels -Oral iron preparations – ferrous therapy as long as it is prescribed
decreased by body iron stores starch or dirt (Due to depletion sulfate, ferrous gluconate, -Iron supplements are usually given 1
dietary deprivation o decreased - Very pale of iron stores) ferrous fumarate hour before taking meals (Iron is best
from undernutrition. hemosiderin content in -Pica -Low hemoglobin (Continue taking for 6 to 12 absorbed on an empty stomach)
the liver & bone marrow - angular cheilosis level months) -Many patients have difficulty tolerating
o decreased -brittle and ridged MCV decreases -Vitamin C facilitates absorption iron supplements because of GI
serum ferritin to 1-35 nails (Due to of iron effects
ug/L - smooth sore tongue diminished iron -IV/IM admin of Iron dextran -Antacids or dairy products should not
• decreased serum -fatigue stores that which can be administered 30 be taken with iron because it
iron and elevated - dyspnea produces small minutes after testing for diminishes its absorption
transferrin (TIBC) -palpitations erythrocytes) anaphylaxis -Liquid forms of iron can stain teeth,
o at this point - red tongue -Low hematocrit (Emergency medications should the patient is instructed to take this
and RBC level be close at hand) medication through a straw to rinse the
the pool of storage iron
-Low serum iron -IM injection causes some local mouth with water, and to practice good
is unable to main-tain
level pain and can stain the skin (Use oral hygiene
the serum iron
-Elevated TIBC Z track technique deep into the -Iron salts may color the stool dark
o the lack of
or Transferrin gluteus maximus muscle or green or black
iron stimulates the
(Measures the buttocks) -Increase Iron rich foods (organ meats)
transcription of the
transport protein -The nurse avoids vigorously other meats, beans, green leafy
transferrin protein
supplying the rubbing the injection site after vegetables, raisins and molasses.
o total iron
marrow with iron the injection
binding capacity (TIBC) as needed)
is an indirect measure-
ment of transferrin
• elevated levels of
free erythrocyte
protoporphyrins (FEP)
o FEP's are
heme precursors which
accumulate in iron de-
ficiency
• RBC structure
affected
o microcytic,
hypochromic,
poikilocytosis
• decreased activity of
intracellular enzymes
containing iron
o catalase,
cytochromes (c, P-450),
peroxidise