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03.02 Iron Deficiency Anemia

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  1. Anemia
    1. ↓ Amount of RBCs or hemoglobin in blood
    2. ↓ Capacity of blood to carry oxygen
    3. 4 Primary types of anemia
      1. Iron-deficiency
      2. Pernicious
      3. Aplastic
      4. Sickle Cell
    4. Iron deficiency is the most common (60% of anemias)

Nursing Points


  1. Iron-Deficiency Anemia
    1. Inadequate iron supply
    2. Babies < 4-6 months will have iron stores from placental circulation.   
    3. 12-36 month at increased risk
      1. ↑ Cow’s milk intake
      2. Picky eating
    4. Adolescents at increased risk
      1. Rapid growth
      2. Poor eating habits
      3. Menses


  1. Pallor
    1. Milk babies
  2. Fatigue & Weakness
  3. Tachycardia
  4. Breathlessness
  5. ↓ Iron levels
  6. Pica – craving non-food substances like ice, dirt, clay, starch.

Therapeutic Management

  1. Increase iron intake in diet
    1. Iron-fortified formula and cereal
    2. Green leafy vegetables
    3. Organ meat
  2. Provide Iron Supplement
    1. Take PO Iron on an empty stomach
    2. With orange juice to reduce stomach ache
    3. Some liquid iron supplements  can stain teeth so give in syringe toward the back of the mouth
    4. Inform parents that the child’s stool will be black

Nursing Concepts

  1. Nutrition
  2. Oxygenation
  3. Health Promotion

Patient Education

  1. Nutrition for Iron-deficiency anemia
    1. Infants
      1. < 6 mo usually have enough iron stores from mom
      2. <1 year offer iron-fortified formula and cereals
    2. Toddlers
      1. Offer small frequent meals to try and increase intake for picky eaters
      2. Minimise milk intake (too much suppresses appetite for solid food and can block iron absorption)
      3. Offer iron-rich foods
        1. Iron-fortified cereal
        2. Red meats
        3. Leafy greens
        4. Fish
        5. Dried fruit
        6. Beans

Reference Links

Study Tools

Video Transcript

Hey you guys, in this lesson we are going to talk about Iron-deficiency Anemia.

Anemia is when the body either doesn’t have enough red blood cells or it doesn’t have enough hemoglobin. Remember, hemoglobin is that part of the red blood cell that is responsible for carrying oxygen. So if the body doesn’t have enough of it, the red blood cells won’t be able to carry the amount of oxygen needed and this results in hypoxia.

There are 4 different types of anemia, Pernicious, Aplastic, Sickle Cell and Iron Deficiency Anemia. Pernicious and Aplastic Anemia are covered in the adult hem/onc course and sickle cell is covered in another peds lesson. This lesson is focusing on Iron Deficiency Anemia.

So a few quick facts to start – First, it accounts for 60% of all anemias, making it the most common. Iron is a essential for the production of new red blood cells and hemoglobin – so if you don’t have iron, your body can’t make these!

For your assessment with iron deficiency anemia you would expect to find pallor, fatigue, increased heart rate and breathlessness. Kids may also try to eat things that are non-edible, like dirt or ice because their bodies know they are missing that nutrient. This is called Pica.

With iron deficiency anemia the causes are usually one of the following 3 things. 1) not enough intake of iron 2) inability absorb the iron they do take in and 3) blood loss. So it’s important to ask patients about their diet and any potential blood loss.

Okay so for the first 4-6 months of life babies have enough iron stores in their body from when they were in utero. Remember RBC’s live for about 120 days. So 120 days after birth the RBC’s they have from mom will start to die and the baby has to start making them on their own. If they dont have iron they cant do this.

Iron deficiency anemia used to be a huge problem for babies, but now that all infant formulas are fortified with iron its less of a problem. So really, the greater risk is for babies that are exclusively breastfed. These babies should be given a supplement until they can start eating more iron rich foods or are started on iron fortified baby cereals.

Toddlers and preschoolers are at risk for iron deficiency because they are likely to be picky eaters and may not be getting enough iron rich foods. Another potential problem is when toddlers and preschoolers are given too much milk to drink. Milk is filling and will likely decrease their appetite for iron rich foods and it can block the absorption of iron. Sometimes you’ll hear these kids referred to as milk babies. They are the very pale 2-3 year old kids that you see walking around with their bottles full of milk. It’s an honest mistake really because parents of picky eaters just naturally think that milk is pretty healthy so at least they are having that, not realizing that it could actually be blocking the absorption of iron in the body. So, parents may need advise on how to get their kids to eat more and in the meantime they may need a supplement.

Adolescents, particularly adolescent females, are at risk for iron deficiency anemia because of rapid growth, poor eating habits and the onset of menses. Dietary changes and supplements may be appropriate for these patients as well.

Management is very simple and straightforward. The first option is to increase dietary intake. This means eating foods like red meats, oily fish, beans, dark green veggies, and dried fruits. Clearly, these are not all the most kid friendly foods so the second option for treatment is to give an iron supplement. Parents need to know the following things about iron supplements: it should always be given between meals, giving with something high in vitamin c like orange juice will help with absorption and it may cause their stools to turn black.

Your priority nursing concepts for a pediatric patient with iron deficiency anemia are nutrition, oxygenation and health promotion.

So, lets recap! Symptoms of anemia are pallor, lethargy and possibly pica. Our primary method of treating iron deficiency anemia is to increase intake, either through diet or with a supplement. Remember each age group has slightly different risks for developing iron deficiency anemia. Keep these in mind as you are talking to families and thinking of your nursing care plans!

“That’s it for our lesson on iron deficiency anemia. Make sure you check out all the resources attached to this lesson. Now, go out and be your best self today. Happy Nursing!”