 What comes to nursing school explained in this video on dietary and supplementation sources of iron and what to teach our patients when they have been diagnosed with iron deficiency anemia. Iron deficiency is the most common anemia, so it's very important that as a nurse you're well versed in what to do when the patient gets diagnosed so that you can help them get back to their iron stores and restore them. So number one should always be for the patient to increase their dietary sources of iron and that is because not only does regular food have other benefits minerals and vitamins that supplementations don't have but also it's more a natural way of doing that. So for patients with mild iron deficiency anemia or for maintenance this might be what's needed. And I always like to point out that there are not only animal-based products or foods that are high in iron as a matter of fact lentils gram-per-gram actually have a higher iron content than beef for example, which is usually what we think about when we think about iron. So for the non animal-based products that contain a lot of iron that is lentils as well as leafy greens especially spinach as well as charred and kale and then tofu and tempeh so anything that soy bean-based quinoa which is a grain that comes from South America that is actually a very excellent source of iron along with fiber and other important nutrients and beans and then pumpkin seeds as well. And then we have the traditional animal-based sources which is beef, oysters, liver and eggs. The reason that I like to point the vegetable or plan-based iron sources out is because many times patients who are at risk for iron deficiency anemia already have other medical problems because such they can be such as people on dialysis or chronic kidney disease that might also have arthro-sclerosis and we know that these animal-based products can cause problems with their cholesterol and then lead to more arthro-sclerosis where on the vegetable-based iron sources we don't really have that risk. So they're typically much better. But whichever your patient prefers always make sure that you recommend for them to take the iron source with vitamin C because vitamin C is what's needed for us to absorb the iron. So the more vitamin C you get directly with your iron source with your intake the better off you'll be in absorbing it. And that can be anything as simple as combining a glass of orange juice with whatever meal that you are having with your food. Now when we look into PO or oral supplementation again we want to take it with vitamin C and again that can be that glass of orange juice or if for some reason it is not possible then you know other sources of vitamin C by food can be can be helpful or another vitamin C supplement to take with your iron supplement. Typically it is recommended to take the dose more than once a day for increased absorption. So the smaller the doses the better the patient will be able to absorb these doses. So if they can take them two or three times a day to come to that total daily dosage that's what's usually better for them. It's best to take iron supplements before meals, but they can cause some stomach upset. So if that occurs the patient can take the supplements with meals as well. And the patients are not supposed to take iron supplements with milk or anti-acids because they can definitely decrease the absorption and we know that we want to get the maximum iron into those patients. Sometimes liquid iron is indicated that is mostly for children and then we want to recommend to take it with a straw because iron is a black liquid and that can actually cause some permanent teeth staining. So the straw kind of helps to bypass the teeth and propels the iron better back in the back of the throat where it can be swallowed right away. Iron supplements can also cause black stools because like I said it's a black substance in liquid form that the patient takes and even the the iron pails can cause some black stools. So very important to distinguish that from a GI bleed. And then the patient is also supposed to get regular blood checks because maybe they don't need the iron supplementation for the rest of their lives just until they have restored their iron stores and then maybe we can revert back to these dietary resources for kind of like a maintenance. And again here if taken PO take with vitamin C. That's probably the most important part for either dietary sources or supplementation that you take it orally because it's better absorbed that way and that way hopefully you will need to be on the supplementation for for that long. If the patient has severe iron deficiency or for some reason they cannot take the iron supplements for some malabsorption issues with their small intestines or maybe the patient is not compliant with their regimen then IM or IV administration can be recommended. When we do give it IM we want to use the Z track method which is where you pull pull the skin that overlies the injection site over to the site and then you inject it into the patient. And as you let go that skin that you pull to the side kind of moves over the injection site. And what that does is prevents staining of the skin because again it is a black liquid. So if you if the patient needs this you know once a week or so they can actually leave tattooing in their skin and then they can have these black dots in their injection site. And we do want to use the gluteus medius muscle for that. If the patient is severely iron deficient and we need to administer iron by the IV that's always possible but be aware that iron might cause allergic reactions. So stay with your patient as best as you can especially the first few times and during the beginning of the administration and also the patient is at risk for phlebitis. So make sure that you get a bigger vein access not only higher up in the arm but also a bigger gauge IV preferably a 20 or an 18 gauge so that it doesn't cause the irritation that leads to phlebitis. Because also if it is extravasates it can cause some staining there too because again the liquid is black. Thanks for watching this video on the PO and dietary sources of iron. Also check out my other videos on the actual anemia of iron deficiency and the other anemias and what it takes to build red blood cells through erythropoiesis. I'll make sure to put all the video links in the description below. Thanks for watching. See you soon.