INDEX

Cover
Index
Dedication
Gratitude
Introduction
Theorico Mark
1. Definition of Pherropenic Anemia
2. Symptom
3. Causes
4. Diagnosis
5. Treatment
6. Treatment Objective
7. Prevention
8. Conclusion
9. Bibliographical references
10. Annexed
 DEDICATION

This monograph is dedicated to our parents, family and colleagues in general and
especially to our teacher who given each day in the learning of the course.
 GRATITUDE

In the first place to God for having given you the necessary time to carry out this
monograph and to our parents for providing conditional support to each of us,
thus achieving that we are one step closer to fulfilling our dream.
 INTRODUCTION

Anemia is not a disease but an indication of another problem; that is why it is

important to detect the cause. In general, the cause is simple and iron stores can
return to their normal level by dieting or taking iron supplements. However,
anemia can be a symptom of something more serious, such as intestinal
bleeding. Therefore iron deficiency anemia should never be ignored.

This type of anemia occurs in the absence of the iron needed to produce
hemoglobin, the protein in red blood cells that carries oxygen throughout the
body. Normally the body has iron stores, red blood cells being an important
source of iron. The red blood cells live about 120 days, and when they die, the
iron they contain is reabsorbed by the body.

Alterations in iron metabolism can consist of syndromes that occur with iron
overload, as in deficit states, representing iron deficiency anemia a global public
health problem, due to its high prevalence. The highest risk population groups
are children, adolescents and women of reproductive age.

Health education, in a nutrition rich in iron, carried out by nursing professionals,

is essential for the positive development of this pathology.
 THEORICO MARK

1. DEFINITION OF PHERROPENIC ANEMIA

Iron deficiency anemia is an alteration caused by a decrease in the number of

red blood cells and a decrease in hemoglobin under the affected parameters. A

deficiency of only one of these factors is rarely recorded independently.

Normal ranges are very variable in each population, levels of environmental

factors (sea level) and geographical. At sea level we will find minimum values,

and at high altitude the required values will be higher (the lower partial pressure

of O2 forces the body to optimize its transport). In addition, we see variations of

sex, observing lower values in women (possibly due to the loss of erythrocytes

and blood content in each menstrual cycle). In general, a hematocrit between 40

and 50%, hemoglobin between 13 and 18 g%, and for a woman: hematocrit

between 37 and 40%, and hemoglobin between 12 and 16 g% can be established

as normal for a man. The symptoms and signs of anemia correlate with its

intensity, its rapidity of installation and the place where they occur. As for its

speed of installation, it can be acute or chronic, the first being more dramatic,

since the chronicle allows a gradual adaptation. Other influential factors in the

symptomatic picture are age, nutritional, cardiovascular and respiratory status.

It is the decrease in the concentration of hemoglobin in the blood. This parameter

is not a fixed value but depends on several factors such as age, sex and certain

special circumstances such as pregnancy.

Anemia is a frequent blood disorder that occurs when the amount of red blood

cells is less than normal, or when the hemoglobin concentration in the blood is

low.
In this case, iron deficiency anemia is a condition in which the body does not have

enough healthy red blood cells. Red blood cells produce oxygen to body tissues.

This type of anemia occurs when the body does not have enough iron. Iron helps

produce red blood cells. Iron deficiency anemia is the most common form of

anemia.

2. SYMPTOM

Anemia produces in the body a series of disorders of a general type that does
not coincide with a specific disease.
Most symptoms of anemia occur as a result of decreased oxygen in the cells or
"hypoxia." Since the red blood cells, through hemoglobin, carry oxygen, the
decrease in production or the amount of these cells produces "hypoxia." Many of
the symptoms do not occur if the anemia is mild, because generally the body can
compensate for gradual changes in hemoglobin.
The following are the most common symptoms of anemia. However, each person
can experience them differently. Symptoms may include, but are not limited to,
the following:

• Abnormal paleness or loss of skin color

• Acceleration of heart rate (tachycardia)
• Respiratory difficulty (dyspnea)
• Lack of energy, or unjustified fatigue (fatigue)
• Dizziness or vertigo, especially when standing
• Headaches
• Irritability
• Irregular menstrual cycles
• Absence or delay of menstruation (amenorrhea)
• Sores or inflammation in the tongue (glossitis)
• Jaundice or yellowing of the skin, eyes and mouth
• Enlargement of the spleen or liver (splenomegaly, hepatomegaly)
• Delay or retardation of growth and development
 • Slow healing of wounds and tissues
The symptoms of anemia may resemble blood disorders or medical problems.
Because anemia is often a symptom associated with another disease, it is
important that your child's doctor be informed of the symptoms that manifest in
the child. Always consult your child's doctor for a diagnosis.

3. CAUSES

There are three main causes of anemia:

• Blood loss (hemorrhage).
• Lack of red blood cell production.
• Increased speed of destruction of red blood cells.

These causes may be the result of several diseases, health problems or other
factors: in the case of blood loss, it may also be caused by the decrease in
platelets or some clotting factor; the lack of red blood cell production can be
motivated by chronic or renal disease and, in the case of rapid destruction of
these blood cells, the cause may be, among others, an inherited spherocytosis,
a disease in which the red blood cells are too fragile due to a genetic problem in
a protein of its structure.

Although red blood cells are produced in various parts of the body, most of their
production is carried out by the bone marrow, white tissue that is in the center of
some bones and that generates blood cells.

Red blood cells that are considered healthy last between 90 and 120 days, period
after which some parts of the body are responsible for removing blood cells.
Erythropoietin is the hormone produced in the kidneys that is responsible for
giving the signal to the bone marrow to produce more red blood cells.

The body needs vitamins, minerals and nutrients such as iron, vitamin B12 or
folic acid to produce red blood cells. The lack of them is motivated by changes in
the stomach or intestines in the process of absorption of nutrients (celiac disease,
for example), insufficient feeding, slow blood loss or surgery in which part of the
stomach or intestines is removed.

Possible causes of anemia can also be:

• Certain medications: In some cases, a medication can cause the immune

system to mistakenly believe that red blood cells are foreign and
dangerous agents. The body responds by creating antibodies to attack its
own red blood cells. These antibodies adhere to these red blood cells and
cause them to be destroyed too early.

• The drugs that can cause anemia are cephalosporins (a type of

antibiotics), penicillin and its derivatives, some non-steroidal anti-
inflammatory drugs or quinidine.

• Disappearance of red blood cells earlier than usual, a consequence that

is usually caused by problems in the immune system.

• Chronic diseases: such as cancer, ulcerative colitis or certain arthritis.

• Heredity is also an important factor in anemia, especially for types such as

thalassemia (when the body produces an abnormal amount of
hemoglobin) or sickle cell anemia (when the blood cells have a
semicircular shape instead of a disk).

4. DIAGNOSIS

To diagnose iron deficiency anemia, the doctor may do tests to determine the
following:

• Size and color of red blood cells. In the case of iron deficiency anemia,
the red blood cells are smaller and paler than normal.
 • Hematocrit. It is the percentage of the volume of blood made up of red
blood cells. Normal levels in general are between 34.9 and 44.5 percent
in adult women, and between 38.8 and 50 percent in adult men. These
values may vary according to age.

• Hemoglobin. Hemoglobin levels below normal indicate anemia. The

normal hemoglobin range is generally between 13.5 and 17.5 grams (g) of
hemoglobin per deciliter (dL) of blood in men, and between 12.0 and 15.5
g / dL in women. Normal levels in children vary by age and sex.

• Ferritin. This protein helps store iron in the body, and a low level of ferritin,
in general, indicates a low level of stored iron.

Additional diagnostic tests

If your blood test indicates that you have iron deficiency anemia, your doctor may
request other tests to identify the root cause, such as:

• Endoscopy. In general, doctors will check for bleeding from a hiatus

hernia, an ulcer or a stomach by endoscopy. During this procedure, a thin,
lighted tube equipped with a video camera is inserted through the throat
to the stomach. This allows the doctor to see both the tube that goes from
the mouth to the stomach (esophagus) and the stomach to look for the
source of bleeding.

• Colonoscopy. To rule out the causes of bleeding in the lower intestinal

tract, your doctor may recommend a procedure called "colonoscopy." A
thin and flexible tube equipped with a video camera is inserted into the
rectum and guided to the colon. Usually, they sedate you during this test.
Colonoscopy allows the doctor to see inside a part of the colon and rectum,
or its entirety, to detect internal bleeding.
 • Ultrasound. Women may also have a pelvic ultrasound to look for the
cause of excessive menstrual bleeding, such as uterine fibroids.

5. TREATMENT

To treat iron deficiency anemia, your doctor may recommend that you take iron
supplements. The doctor will also treat the underlying cause of iron deficiency if
necessary.

Iron supplements

Your doctor may recommend over-the-counter iron tablets to replenish the supply
of iron in the body. Your doctor will inform you about the correct dose for you. Iron
is also available in liquid form for infants and children. To improve your body's
chances of absorbing iron from tablets, you may be instructed to do the following:

• Take iron tablets on an empty stomach. If possible, take them without

having eaten before. However, because iron tablets can cause stomach
upset, you may need to take them with meals.

• Do not take iron with antacids. Medications that immediately relieve the
symptoms of heartburn can affect iron absorption. Take iron two hours
before or four hours after taking antacids.

• Take iron tablets with vitamin C, which improves iron absorption. Your
doctor may recommend that you take them with a glass of orange juice or
with a vitamin C supplement.

• Iron supplements can cause constipation, so your doctor may also

recommend a stool softener. Iron can darken stool, which is a harmless
side effect.

• Iron deficiency cannot be corrected immediately. You may need to

take iron supplements for several months or more to replenish iron stores.
 Usually, you will begin to feel better after a week or so of treatment. Ask
the doctor when you should have a blood test again to measure the iron
level. To ensure the replenishment of your iron stores, you may have to
take iron supplements for a year or more.

6. TREATMENT OBJECTIVE

The goal of treatment is to increase the amount of oxygen that blood can carry.
This increase is achieved by increasing the number of red blood cells or the
concentration of hemoglobin (hemoglobin is a protein of red blood cells rich in
iron and that carries oxygen to the body's cells). Another objective is to treat the
underlying disease or the cause of anemia.

Changes in food and nutritional supplements:

• iron
• B12 vitamin
• Folic acid

Blood transfusion and transplantation of blood stem cells and bone marrow are
two treatments that have to be previously evaluated by the specialist to determine
the true need.

7. PREVENTION

It is possible to prevent repeated episodes of certain types of anemia, especially

those due to lack of iron or vitamins. If changes are made in the diet or
supplements (recommended by the doctor) can prevent these types of anemia
from reoccurring.
Treatment of the cause can prevent anemia (or prevent recurrence). For
example, if a medication is causing anemia to the patient, the doctor may
prescribe another type of medicine.
To prevent anemia from getting worse, it is necessary for patients to explain in
detail to the doctor all their signs and symptoms. It is also recommended to ask
what tests have to be done and comply with the treatment plan.
Some types of inherited anemias, such as sickle cell anemia, cannot be
prevented. In the case of suffering from hereditary anemia, it is necessary for
patients to consult their doctor about the treatment and ongoing care they need.

8. CONCLUSION

Iron deficiency anemia is a pathology in the blood that is characterized by the

decrease in the normal level of total hemoglobin (<11 g / dl), due to a problem in
the use of iron present in the diet, the population being more affected children
and pregnant women.

The etiology of iron deficiency anemia is attributed to the deficiency in the diet of
heminic iron or the alteration in its absorption by pathologies referred to blood
loss or deficiency in the bioavailability of iron.
For the diagnosis, the hematological parameters allow a quick recognition of the
pathology, but it is the biochemical tests of the serum that allow a differential
between other types of anemia, such as hemolytic and megaloblastic.

The treatment of choice is the application of iron supplements, orally and

venously, for which according to age, sex and laboratory results the dose is
recommended, which has a greater benefit if accompanied with vitamin C.

Iron deficiency anemia is a global health problem that can be controlled thanks
to the efforts of the authorities, which is why its continuous study promotes good
development in the most vulnerable population such as children and pregnant
women.
9. BIBLIOGRAPHICAL REFERENCES

• Sánchez FJ and Grupo Previnfad / PAPPS Children and Adolescents.

Prevention and screening of iron deficiency in infants. Rev Pediatr Aten
Primary. 2012; 14: 75-82.

• https://cuidateplus.marca.com/enfermedades/enfermedades-vasulares-y-
del-corazon/anemia.html#prevencion.

• Hoffmann JJ, Urrechaga E, Aguirre U. Discriminant indices for

distinguishing thalassemia and iron deficiency in patients with microcytic

anemia: a meta-analysis. Clin Chem Lab Med. 2015; 53: 1883-94 .

10. ANNEXED