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Ibrahim R. Ayasreh Taif University

Anemia, per se, is not a specific disease state but a

sign of an underlying disorder.

It is by far the most common hematologic condition. Anemia, a condition in which the hemoglobin

concentration is lower than normal, reflects the presence of fewer than normal RBCs within the circulation. As a result, the amount of oxygen delivered to body tissues is also diminished.

Etiological categories of anemia

Loss of RBCs : occurs with bleeding, potentially from

any major source, such as the gastrointestinal tract, the uterus, the nose, or a wound. Decreased production of RBCs : can be caused by a deficiency in cofactors (including folic acid, vitamin B12, and iron) required for erythropoiesis; RBC production may also be reduced if the bone marrow is suppressed (eg, by tumor, medications, toxins) or is inadequately stimulated because of a lack of erythropoietin (as occurs in chronic renal disease). Increased destruction of RBCs : may occur because of an overactive RES (including hypersplenism) or because the bone marrow produces abnormal RBCs that are then destroyed by

Classifications of anemia

Classifications of anemia

Classifications of anemia

Clinical manifestations
The most common symptom is fatigue. Shortness of breath Dizziness Headache Coldness in the hands and feet Pale skin Chest pain

Iron deficiency anemia

Results when the intake of dietary iron is inadequate for hemoglobin

Iron deficiency anemia is the most common type of anemia in all age

groups, and it is the most common anemia in the world.

In children, adolescents, and pregnant women, the cause is typically

inadequate iron in the diet to keep up with increased growth.

The most common cause of iron deficiency in men and postmenopausal

women is bleeding (from ulcers, gastritis, inflammatory bowel disease, or gastrointestinal tumors). The most common cause of iron deficiency anemia in premenopausal women is menorrhagia (excessive menstrual bleeding) and pregnancy with inadequate iron supplementation.

Clinical manifestations
Signs and symptoms of general anemia.
Smooth, sore tongue. Brittle and ridged nails. Angular cheilosis (an ulceration of the corner of the


Assessment and Diagnostic Findings

Low Ferritin.
Low Hemoglubin. Low MCV. Low RBCs count.

Medical Management
Several oral iron preparationsferrous sulfate, ferrous

gluconate, and ferrous fumarateare available for treating iron deficiency anemia. tolerated, or iron supplementation is needed in large amounts. In these situations, intravenous or intramuscular administration of iron dextran may be needed.

In some cases, oral iron is poorly absorbed or poorly

Nursing Management
Encourage eating food sources high in iron include organ

meats (beef or calfs liver, chicken liver), other meats, beans (black, pinto, and garbanzo), leafy green vegetables, raisins.
Taking iron-rich foods with a source of vitamin C enhances

the absorption of iron.

Because iron is best absorbed on an empty stomach,

patients should be advised to take the supplement an hour before meals.

Nursing Management
Antacids or dairy products should not be taken with iron,

because they greatly diminish the absorption of iron.

Liquid forms of iron that cause less gastrointestinal distress are

available. However, they can stain the teeth; patients should be instructed to take this medication through a straw, to rinse the mouth with water, and to practice good oral hygiene after taking this medication.
Finally, patients should be informed that iron salts may color

the stool dark green or black. However, iron replacement therapy does not cause a false-positive result on stool analyses for occult blood.

Nursing Management
The intramuscular injection causes some local pain and can

stain the skin.

These side effects are minimized by using the Z-track

technique for administering iron dextran deep into the gluteus maximus muscle (buttock).
Avoid vigorously rubbing the injection site after the

Because of the problems with intramuscular administration,

the intravenous route is preferred for administration of iron dextran.