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1.Blood loss
Blood lost causes iron depletion
In women, long or heavy menstrual periods or bleeding fibroids
in the uterus.
Childbirth
Internal bleeding
2.Poor Diet
Low iron intake.
During some stages of life,like pregnancy and children
3.Inability To Absorb Enough Iron
Even if you have enough iron in your diet, your body
may not be able to absorb it. This can happen if you have
intestinal surgery or a disease of the intestine.
Prescription medicines that reduce acid in the stomach
also can interfere with iron absorption.
brittle nails SIGNS & SYMPTOMS
cracks in the sides of the mouth
chest pain
Pale skin
Fast heart rate
Headache
an enlarged spleen
Cold hands and feet
frequent infections.
Irritability
shortness of breath
swelling or soreness of the tongue
An unusual craving for non-nutritive
An unusual craving for non-nutritive substances such as:
Ice
Dirt
Paint or starch.
This craving is called pica.
Some people who have iron-deficiency anemia develop restless legs
syndrome(RLS). RLS is a disorder that causes a strong urge to move the
legs.
Some signs and symptoms of iron-deficiency anemia are related to the
condition's causes.
A sign of intestinal bleeding is bright red blood in the stools or black,
tarry-looking stools.
Very heavy menstrual bleeding, long periods,or other vaginal bleeding
may suggest that a woman is at risk for iron-deficiency anemia.
PATHOPHYSIOLOGY
Iron deficiency anemia is the most common form of anemia and it
develops over time if the body does not have enough iron to
manufacture red blood cells.
Without enough iron, the body uses up all the iron it has stored in
the liver, bone marrow and other organs.•
Once the stored iron is depleted, the body is able to make very
few red blood cells.
If erythropoietin is present without sufficient iron, there is
insufficient fuel for red blood cell production
The red blood cells that the body is able to make are abnormal
and do not have abnormal hemoglobin-carrying capacity, as do
normal red blood cells.
TREATMENT
IRON SUPPLEMENT
IMPORTANT POINTS ABOUT IRON
SUPPLEMENT
Before using iron medication, check if you are allergic to any
drugs or food dyes, or if you have:
iron overload syndrome
hemolytic anemia (a lack of red blood cells)
porphyria (a genetic enzyme disorder that causes symptoms
affecting the skin or nervous system)
thalassemia (a genetic disorder of red blood cells)
liver or kidney disease
if you are an alcoholic; or
if you receive regular blood transfusion.
Most iron medication are taken on an empty stomach, at least 1
hour before or 2 hours after meal.
TREATMENT OF IRON DEFICIENCY
ANEMIA
Iron deficiency anemia is treated with oral or parenteral
iron preparation. Oral iron corrects the anemia just as
rapidly and completely as parenteral iron in most cases if
iron absorption from the GIT is normal.
Different iron salt provide different amount of elemental
iron.
In iron deficient individual, about 50-80mg of iron can be
incorporated in hemoglobin daily and about 25% of oral
ferrous salt can be absorbed.
• Oral iron treatment may require 3-6 months to
replenish body stores.
• .
Common adverse effects of oral iron therapy
NAME : Mrs.Annapurna
AGE : 30 years
GENDER : Female
IP NO : R117 - 016014
COMPLAINTS
CHIEF COMPLAINTS:
• Generalized weakness since 4 days.
PERSONAL HISTORY
DIET: MIXED
APPETITE: DECREASED
BOWEL & BLADDER :REGULAR
SLEEP : ADEQUATE .
VITALS
CVS : Pan systolic murmur
PR : 100 / min.
BP : 110/ 80 mmHg
RS : BAE , lungs clear .
CNS : NAD
ABDOMEN : Mild hepatomegaly.
DAY-1
C/O : SOB on exertion
Cough since yesterday
Generalized weakness
VITALS :
BP : 110/80 mmHg, PR :80 b/ min .
RR : 30 b/min , RS : lungs clear .
VITALS :
BP : 110/80 mmHg, PR :80 b/ min .
RR : 30 b/min , RS : lungs clear
CVS : Pan systolic murmur .
VITALS:
BP : 110/70 mmHg, PR :72 b/ min .
RR : 30 b/min , TEMP : afebrile
Rx:
INJ Optineuron 1amp in 100ml NS
1 UNIT of PCV transfusion with pre medication
Stopped TAB Azee
DAY-4
C/O : Cough ,SOB on exertion
No other fresh complaints
GC better.
VITALS:
BP : 100/70 mmHg, PR :90 b/ min .
RR : 20 b/min , TEMP : afebrile
Rx:
Continue same treatment.
Added TAB Orofer XT OD
DAY-5
C/O : No fresh complaints,
Patient is feeling better,
Discharged.
DISCHARGE MEDICATIONS:
Objective evidence:
Decrease in levels of Hemoglobin , RBC count ,ferritin
and iron results diagnosing the disease iron deficiency
anemia
Assessment
PROBLEM 1 : iron deficiency anemia(palpitations, pallor, SOB, fatigue )
Lab reports and patients complaints confirmed IDA
Medications: Tab Livogen
Tab orofer XT
pcv transfusion
PROBLEM 2 : infection(Cough)
Medications : azithromycin.
After starting intial treatment Of inj livogen for (IDA),patient developed loss of
appetite and sleeping disturbances.
Patient counsellimng
• ABOUT THE DISEASE
Anemia is a condition in which the body does not have enough healthy red blood
cells. When your body does not have enough iron, it will make fewer red blood
cells or red blood cells that are too small. This is called iron deficiency anemia.
You get iron deficiency anemia when your body's iron stores run low. You can get
iron deficiency if:
• You lose more blood cells and iron than your body can replace
• Your body does not do a good job of absorbing iron
• Your body is able to absorb iron, but you are not eating enough foods with iron
symptoms may include:
Feeling weak or tired more often than usual, or with exercise.
Headaches, Problems concentrating or thinking,Blue color to the whites of the eyes,
Brittle nails, Light-headedness when you stand up , Pale skin color , Shortness of
breath,
Sore tongue , Dark, tar-colored stools or blood , Heavy menstrual bleeding
(women)
Pain in the upper belly (from ulcers),Weight loss.
About the medications:
1. Azithromycin: You may take most forms of azithromycin with or without
food.Do not take in larger or smaller amounts or for longer than recommended.
Follow the directions on your prescription label.
2. Livogen : Take Ferrous Fumarate and Folic Acid on an empty stomach, at least
1 hour before or 2 hours after a meal. Do not take extra medicine to make up the
missed dose
4. parasafe : avoid using if allergic to thus drug . Take the missed dose as soon as
noticed and if it is the time for next dose then skip the missed dose. Continue the
regular schedule.
5. Pantoprazole : You can take this form with or without food. Take at the same time
every day for best effects. Don’t cut, crush, or chew this medication.
Lifestyle modifications
Drink adequate amounts of water prevent dehydration and the likelihood for sickle
cell problems.
Keep you body refreshed during extreme cold and hot temperatures since exposure
to these extremes can enhance the likelihood of sickle cell problems. so you need to
reduce stress all the time Your body is prone to sickle cell problem when you’re
subjected to too much stress.
Some types of anemia can be managed with a healthy, balanced diet rich in iron,
vitamin B12, folate, and vitamin C, which helps your body absorb iron. meat is a
main source of nutrients.
Take iron rich food like:
• Iron is found in red meat, poultry, and some fish (such as salmon, tuna, shrimp).
Other iron-rich foods include beans, lentils, dark green leafy vegetables, dried fruit,
nuts, soy, and iron-fortified cereals and breads.
• Folate is found in fortified cereals, meat, spinach, beans, citrus fruits and juices,
cantaloupe, papaya, and bananas.
• Vitamin B12 is most plentiful in meat, fish, and dairy products, as well as fortified
cereals.
• Vitamin C is found in citrus fruits, melons and berries, bell peppers, broccoli,
Brussels sprouts, and kale.