‫‪IRON DEFICIENCY ANEMIA‬‬

‫‪.‬ﻟﯿﻨﺎ ﻧﻀﺎل‬ ‫اﺷﺮاف اﻟﺪﻛﺘﻮرة‬

‫اﻋﺪاد \‬
‫ﻧﺮﺟﺲ ﺟﺒﻮري ﻋﺒﺎس‬ ‫ﻣﮭﺎ ﻧﻈﯿﺮ ﻣﺠﯿﺪ‬
‫ﺣﻨﯿﻦ ﺳﻠﯿﻢ‬ ‫اﻛﺮم ﺣﺴﻦ ﻣﮭﺪي‬
‫ﻧﻮر ﺳﺎﻣﺮ ﻏﻈﺮﯾﻒ‬
 Introduction
Iron-deficiency anemia is caused by blood loss, insufficient
.dietary intake, or poor absorption of iron from food
Sources of blood loss can include
heavy periods, childbirth, uterine fibroids, stomach
ulcers, colon cancer, and urinary tract bleeding Poor
absorption of iron from food may occur as a result of an
intestinal disorder such as inflammatory bowel
disease or celiac disease, or surgery such as a gastric
,bypass In the developing world, parasitic worms, malaria
and HIV/AIDS increase the risk of iron deficiency
anemia Diagnosis is confirmed by blood tests
Iron-deficiency anemia affected about 1.48 billion people
in 2015 A lack of dietary iron is estimated to cause
approximately half of all anemia cases globally Women
,and young children are most commonly affected In 2015
anemia due to iron deficiency resulted in about 54,000
deaths – down from 213,000 deaths in 1990
 Definition
A disease that occurs when the body does not have an
,adequate amount of healthy red blood cells or hemoglobin
which leads to a decrease in the process of transporting
oxygen from the lungs to the tissues, and leads to
complications that may be severe
Iron helps move oxygen from the lungs to the rest of the
body and helps muscles store and use oxygen. If your
child's diet lacks iron, he may develop a condition called
.iron deficiency
Iron deficiency in children is a common problem. It can
occur on many levels, from a mild deficiency to iron
deficiency anemia — a condition in which the blood does
not contain enough healthy red blood cells. Untreated
iron deficiency can affect a child's growth and
developmen
 Pathophysiology
Iron is vital for all living organisms because it is essential
for multiple metabolic processes, including oxygen
.transport, DNA synthesis, and electron transport
Iron equilibrium in the body is regulated carefully to ▪
ensure that sufficient iron is absorbed in order to
.compensate for body losses of iron
Whereas body loss of iron quantitatively is as important ▪
,as absorption in terms of maintaining iron equilibrium
.it is a more passive process than absorption
In healthy people, the body concentration of iron ▪
is regulated (approximately 60 parts per million [ppm])
carefully by absorptive cells in the proximal small
intestine, which alter iron absorption to match body
losses of iron
 Persistent errors in iron balance lead to either iron ⚫
deficiency anemia or hemosiderosis. Both are disorders ⚫
.with potentially adverse consequences ⚫
Iron uptake in the proximal small bowel occurs by 3 ▪ ⚫
separate pathways; these are the heme pathway and 2 ⚫
.distinct pathways for ferric and ferrous iron ⚫
numerous Heme iron is not chelated and precipitated by ▪ ⚫
dietary constituent that renders nonheme iron ⚫
,nonabsorbable, such as phytates, phosphates, tannates ⚫
oxalates, and carbonate ⚫
 Symptoms
If the iron is too low, your child's ability to function
well
may be impaired. However, most signs and
symptoms of
iron deficiency in children don't appear until iron
deficiency anemia occurs. If your child has risk
factors for
.iron deficiency, talk to his or her doctor
Signs and symptoms of iron deficiency anemia may
include
 pallor of the skin .1
fatigue .2
cold hands and feet .3
slow growth and development .4
poor appetite .5
Abnormal rapid breathing .6
behavioral problems .7
Frequent infections .8
,Unusual cravings for non-food items, such as ice, dirt .9
paint, or starch
 Complications
Mild iron deficiency anemia usually
doesn't cause
complications. However, left untreated,
iron deficiency
anemia can become severe and lead to
,health problems
:including the following
Heart problems: Iron deficiency anemia may lead to a ⚫
rapid or irregular heartbeat. Your heart must pump ⚫
more blood to compensate for the lack of oxygen ⚫
carried in your blood when you're anemic. This can ⚫
.lead to an enlarged heart or heart failure ⚫
,Problems during :pregnancy. In pregnant women • ⚫
severe iron deficiency anemia has been linked to ⚫
premature births and low birth weight babies. But the ⚫
condition is preventable in pregnant women who ⚫
receive iron supplements as part of their prenatal ⚫
.care ⚫
Growth problems:In infants and children, severe iron • ⚫
deficiency can lead to anemia as well as delayed ⚫
growth and development. Additionally, iron ⚫
deficiency anemia is associated with an increased ⚫
.susceptibility to infections ⚫
 Nursing Management
Nursing care of a child with iron deficiency anemia ⚫
include
:the following ⚫
Nursing Assessment ⚫
:Assessment of the child include ⚫
;Dietary history. A dietary history is important .1 ⚫
vegetarians are more likely to develop iron deficiency ⚫
unless their diet is supplemented with iron; national ⚫
programs of dietary iron supplementation are initiated ⚫
in many portions of the world where meat is sparse in ⚫
the diet and iron deficiency anemia is prevalent ⚫
 History of hemorrhage. Bleeding is the most
common
cause of iron deficiency, either from parasitic
infection
or other causes of blood loss; with (hookworm)
bleeding
,from most orifices (hematuria, hematemesis
hemoptysis), patients will present before they
develop
,chronic iron deficiency anemia; however
.gastrointestinal bleeding may go unrecognized
Physical exam. Anemia produces nonspecific ⚫
pallor of
the mucous membranes; a number of ⚫
abnormalities of
epithelial tissues are described in association ⚫
with iron
deficiency anemia; these include esophageal ⚫
,webbing
koilonychia, glossitis, angular stomatitis, and ⚫
gastric
.atrophy ⚫
 Nursing Diagnosis
Based on the assessment data, the major nursing ⚫
:diagnoses are ⚫
Fatigue related to decreased hemoglobin and • ⚫
.diminished oxygen-carrying capacity of the blood ⚫
Deficient knowledge related to the complexity of • ⚫
treatment, lack of resources, or unfamiliarity with the ⚫
.disease condition ⚫
Risk for infection • ⚫
Risk for bleeding • ⚫
 Nursing Interventions
Advise patient to take iron supplements an hour.1
before
meals for maximum absorption; if gastric distress
— occurs, suggest taking the supplement with meals
.resume to between-meals schedule if symptoms subside
Inform patient that iron salts change stool to dark .2
green
.or black
Advise patient to take liquid forms of iron via a straw .3
and rinse mouth with water
 References
Hockenberry, M. J., Wilson, D.(2013) Wong’s ⚫
:Essentials of Pediatric Nursing, 8th edition. USA ⚫
.Elsevier, PP 101, 102, 103,104,105 ⚫
Potts, N. L. and Mandleco, B. L., (2012) Pediatric • ⚫
Nursing Caring for Children and Their Families. 3th ⚫
.edition. USA: DELMAR CENGAGE Learning, pp ⚫
.411,412,413 ,410 ⚫
Ricci, S. S., Kyle, T. and Carman, S.(2013) Maternity • ⚫
and Pediatric Nursing. 2nd edition. China: Wolters ⚫
.Kluwer Health | Lippincott Williams & Wilkins pp ⚫