Iron-Deficiency Anemia, Case Study Example

Anemia refers to a condition in which an individual’s blood has exceedingly low oxygen-carrying potential. There are three pinpointed causes of anemia: a dearth of healthy red blood cells; decreased hemoglobin levels; and abnormal hemoglobin content (CDC, 1998). However, it is clear that Ms. A suffers from iron-deficiency anemia, which requires a general explanation of the causes, signs and symptoms, treatment, and nursing implications. Iron-deficiency anemia is caused by heavy menstrual periods, poor iron absorption, pregnancy, bleeding in the intestines, bleeding from the kidneys, a less than optimal diet, hookworm infection, and some medications including ibuprofen, aspirin, diclofenac, and naproxen. Patients who suffer from iron-deficiency anemia exhibit general weakness or tiredness, dizziness or faintness, shortness of breath especially upon exertion, enhanced irritability, soreness in the mouth, and/or pale face (Mehta, 2004). This condition is diagnosed after a physician or nurse practitioner conducts a physical examination, takes a full medical history, and draws blood in order to conduct an iron studies and full blood count. Iron deficiency anemia is characterized by low serum iron and ferritin, low mean corpuscular volume (MCV), amplified sum of iron-binding capacity, and low Hb (CDC, 1998). All patients suspected of having this condition should undergo gastrointestinal investigation by the nurse unless the medical history indicates that there is no significant non-gastrointestinal blood loss (CDC, 1998). Treatment is preventative in nature as it zeroes in on preventing any more loss of iron in the future. As such, patients are directed to ingest iron supplements—especially for women like Ms. A during their menstrual cycle—to provide a corrective for their anemia and to replenish iron stores in their bodies. The suggested dose of ferrous sulfate is 200 mg three times a day. Ferrous fumarate and ferrous glocunate have also been rendered quite effective as well. Supplements should be taken at a minimum of three months after diagnosis in order to ensure that iron stores have been sufficiently replenished. Once a patient’s anemia has been corrected, the red cell indices in addition to Hb concentration must be carefully monitored every three months for at last one year. If this is not feasible, further investigation is crucial to ensure that this condition does not return.

The patient, Ms. A., is an apparently healthy young Caucasian woman who experiences shortness of breath and low energy levels/lack of enthusiasm. Upon exertion, she has trouble breathing and feels light-headed at faint, such as the time when her friend had to take her to the emergency clinic when she felt light-headed while golfing. When she is menstruating, these symptoms are exacerbated. Anytime an person loses blood, their iron levels always decrease, which is why Ms. A.’s symptoms worsen when she is on her menses. The more anemic an individual gets, their heart rate hastens and their blood pressure goes down. The attending physician at the emergency clinic notes her elevated heart rate and respiratory of rate due to her shortness of breath in addition to her low blood pressure. Ms. A. tells the physician that she has dealt with menorrhagia as well as dysmenorrheal for approximately 10-12 years, which is why she takes aspirin quite frequently: 1,000 mg every 3-4 hours when she is menstruating.  In addition, when she plays golf, she also takes a high volume of aspirin so that her joints do not become. Ingesting such a high level of aspirin can cause some degree of bleeding as well, thereby further losing iron in the process. Ms. A.’s hemoglobin level is at 8, but the normal hemoglobin level falls between 12. Finally, the number one cause of iron-deficiency anemia is hypochromic cells, which Ms. A’s test results detected in her blood stream.

This case study on Ms. A. as a young woman diagnosed with iron-deficiency anemia has various implications for nurses. As advocates and educators, nurses must educate their patients on the nature of the condition and possible warning signs. In addition, patients need to better understand how to enhance their healthy lifestyles via a good diet, offering advice to them on what foods have ample iron. Patients also must fully understand the dose, duration, and side effects of the iron supplements they are taking, including when they should take the supplements. Finally, nurses must underscore the importance of patients reporting any and all of their medical symptoms. There is ongoing research regarding the significance of stratifying for risk of debilitating disease related to Hb levels in addition to the currency of computerized tomography colonography in the evaluation and assessment of iron-deficiency anemia, especially among women (CDC, 1998). Iron-deficiency anemia is a ubiquitous disease that can be corrected quite easily if people are cognizant of the warning signs.

References

CDC. (1998). Recommendations to prevent and control iron deficiency in the United States. MMWR, 47(3).

Mehta B.C. (2004).  Iron deficiency amongst nursing students. Indian Journal of Medical Science, 58, 389-399.

Nojilana, B., Norman, R., Dhansay, M.A., et al. (2000). Estimating the burden of disease attributable to iron deficiency anemia in South Africa. South African Medical Journal, 97, 741-746.