Pathologic Conditions
- Definition: A reduction in the number of circulating red blood cells or the amount of hemoglobin.
- Pathophysiology: Iron stores are depleted, serum iron levels fall, and clinical symptoms develop as hemoglobin is inadequate to carry oxygen to body tissues.
- Etiology: Inadequate iron intake, malabsorption of iron, chronic blood loss, hemolysis, or pregnancy.
- Manifestations: Pallor (paleness), fatigue, vertigo, headache, dyspnea, tachycardia, and amenorrhea.
- Med Tx:Child: Oral ferrous sulfate or ferrous gluconate, well-balanced diet to include 2 mg/kg of iron each day, vitamin C, intramuscular administration of iron for severe cases, and identification and treatment of excess blood loss. Adult:100 to 200 mg/day in 3 divided doses. Continue treatment 4 to 6 mos after lab values are normal to replace iron stores.
- Nsg Dx: Altered nutrition, less than body requirements; activity intolerance; knowledge deficit.
- Nsg Care: Administer iron preparation with citrus. Avoid giving iron with alkaline foods or antacids. Give liquid preparation through a straw or behind teeth with dropper. Teach regarding foods high in iron and administration of iron preparations. Monitor response to therapy (adequate response is indicated by reticulocyte count rise, then, after 5 to 10 days of therapy, hemoglobin rise of 0.17 to 0.25 g/dL/day or about 3.4 to 6.25 g/dL/mo).
- Prognosis: Excellent with regimen compliance and cessation of excess iron losses that may be caused by bleeding.