 What come to nursing school explain in this video on iron deficiency anemia, which is the most common type of anemia that we see out there? As always, let's go ahead and look at the physiology first. So remember that an red blood cell is kind of this disc-shaped cell that has a small molecule attached to it that's called the hemoglobin and the hemoglobin itself is the one that actually carries the oxygen on the red blood cell and the heme of the hemoglobin contains the iron and then it's bound to this carrier protein called globin which makes up this name hemoglobin and The iron like I said here carries the oxygen so without iron We don't have the oxygen carrying capacity and the patient is going to have symptoms Now what causes iron deficiency anemia first of all it can be decreased dietary intake Because people or some patients might not get enough iron in their diets It also during increased Or rapid periods of growth such as in infants children and even adolescents when they go through growth spurts There is more iron needed and so Patients can come to be deficient there and then when there is any kind of malabsorption Because iron gets absorbed in the small intestine. So if we have any issues with the small intestine where the iron usually gets absorbed We're going to be lacking in the iron that we need heavy men's see so this is for pre menopausal women who Lose blood through their menstrual cycle that is very heavy and therefore they can become iron deficient And then patients with GI bleed and that is not something that would be an acute GI bleed where you see this bright red blood This would be more like a polyp or some sort of a growth in their intestine That is slowly leaking blood Maybe not even detected by the patient but slowly over months at a time the patient loses blood And then it leads to iron deficiency and then also patients on dialysis are at risk for iron deficiency anemia Because first of all there their blood gets filtered through the equipment so there can be some trauma there and second of all they have to get frequent blood sampling Because of checking their labs and so they also become can become iron deficient in addition to chronic kidney disease Which actually can lead to anemia of chronic disease, which is a little different physiology But just know that patients with dialysis are kind of at risk for both And then for any kind of trauma to the red blood cells and so I put here IVC filter inferior vena cava filter or heart valve so anything that's implanted in the patient That's mechanical and prosthetic that those blood cells go through as they pass through These artificial valves or that filter they might get damaged and therefore The red blood cells get cycled out and we lose that iron And so for from a pathophysiological standpoint when we have decreased iron in our bodies it leads to microcytic and hypochromic red blood cells and that means that the cells are smaller than expected and hypochromic they're also more pale in color and So then the iron gets pulled from the stores in the liver But as they deplete we lose our oxygen-carrying capacity and then the patient starts to have symptoms So science and symptoms for iron deficiency anemia They might develop very slowly as I put right here because think about this example I gave here with the GI bleed This is a very slow Continuous leak that occurs over several months and the patient initially might not have any symptoms because their body is trying to Compensate for the loss of iron and blood cells But then eventually once it gets to a certain point then they start having symptoms and they might pretty sick pretty significant So the patient might have this neon exertion because they just don't have the oxygen-carrying capacity They might feel fatigued they might also be pale because we were losing red blood cells and the iron that gives the color and Then in response as we're losing blood we're becoming hypovolemic So in there in response the heart rate will go up blood pressure will go down and also in response to decreasing these Oxygen molecules that the iron is carrying the patient's respiratory rate will go up because the body is trying to pull in more oxygen to the blood cells that are available and Then there are three different things here or special terms that we also here with iron deficiency anemia Which is coelonechia which are spoon-shaped nails and you can Google search what that looks like and then patient also may have Glossitis which is a sore red tongue or cell light is which are wrecked red and cracked lips So then as for complications when we lose a lot of blood It actually leads to increased bleeding because we're losing blood the platelets everything is used up And then the patient it can lead to bleeding also because we just don't have the oxygen That supplies the nutrients for healing the patient is more at risk for infection And then this phenomenon named pica happens where patients crave Non-food items and the classic example here is always Wallpaper or wallpaper paste. I don't know who came up with that, but that's the classic example for pica So for a diagnostic test typically on a CBC on a complete blood count it is first detected that the red blood cells and the hemoglobin and hematocrit are low and Then we also look into the red blood cell indices that I have a separate video that goes more into Explaining these and because we said over here we have those Microcytic and hypochromic so small and pale red blood cells It'll show up in the in the CBC as a low MCV mean corpuscular volume and the low MCH mean corpuscular hemoglobin And then also the ferritin will be low the total iron binding capacity will be increased because now the iron that's binding To these hemoglobin modules is actually they're all used up because we just don't have enough iron Available in the bloodstream and of course serum iron will go down But then also not only are we going to look at these red blood cell indices But we're also going to have to look out and rule out others causes of The symptoms that the patient is experiencing with me which may be thalassemia, which is another type of anemia any kind of cancer And any chronic liver and kidney disease because we always know those are involved with Producing and recycling the red blood cells So treatment we always want to make sure we educate patients at risk all these risk factors that we talked about over here So dialysis patients in particular patients with heart valves We want to make sure patients either well-balanced diet premenopausal women and those with Malabsorption that they are at risk for iron deficiency anemia so that we educate them to actually get enough iron in their diet number two would be increasing dietary sources and those are not only as you see in so many textbooks animal-based products such as red meat and Dairy products actually there's a lot of iron available in pretty big abundance and good percentages for for the amount of portions that you have to eat in Lento so those are a very very big great source of iron as well as any kind of green leafy vegetables so if we have patients who might need to adhere to a More balanced diet and maybe stay off the animal products This would be something that we would recommend to them and dietary sources of iron should always be consumed with vitamin C So this might be if you recommend something with green leafy vegetables that they also have maybe Some source of vitamin C with it Which could be like an orange or a bell pepper a red bell pepper that kind of increases the absorption of the iron making sure The patient gets enough iron not only in their diet But they are also able to absorb it and then for PO replacement It's also recommended to take with vitamin C and I'll talk about that separately And then we can also if the deficiency is severe or there are some malabsorption concerns. We can give it IM or IV So for our nursing considerations We certainly need to assess the patients for all the signs and symptoms that we talked about including those of bleeding and then assess their vital signs Hard rate blood pressure respiratory rate because they might turn to be hypovolemic as they are slowly bleeding from From one or another source and then also look at their labs And this is something that I encourage you to do take a good look at these red blood cell indices So you could really be familiar sometimes those can be a little bit Difficult to understand but once you have a pretty good understanding of what they represent it really helps to understand and Then of course we want to educate the patient like I already talked about And then we want to make sure that we give the patient the correct information for iron supplementation Not only for the dietary sources, but also for PO replacement And because this is such an important topic and it is the most common anemia I've made a separate video that discusses all the nutritional Things that we need to teach our patients for replacing PO iron When it comes to im injections We want to use the z-track method and that is mostly because iron is actually a black fluid And if we give that in a regular way Without the z-track moving the skin over then it actually can cause some skin Staining over time and then eventually it can look like a tattoo As you pull the needle out and a little bit of the medicine comes with it So the z-track method is always recommended there And if the patient needs it IV they are at risk for adverse reaction So especially when they get it for the first couple of times You want to make sure you stay with the patient In the at the beginning of the infusion to make sure that they are not Experiencing any of those. Thanks for watching nursing school explained Please also check out the other videos that pertain not only to erythropoiesis How red blood cells are actually produced as well as the labs that we talked about over here And the other anemias there are types of anemias that are not as common But also very prevalent in our patient population. So you have a better understanding Thanks for watching nursing school explained. See you soon