Page 1307 - Saunders Comprehensive Review For NCLEX-RN

1. Pallor
2. Weakness and fatigue
3. Low hemoglobin, hematocrit, and mean cellular
volume (MCV) levels
4. Red blood cells that are microcytic and hypochromic
C. Interventions
1. Increase oral intake of iron and instruct client in food
choices that are high in iron (see Box 11-2 in Chapter
11 for iron-rich foods).
2. Administer iron supplements as prescribed.
3. Intramuscular injections of iron (using Z-track
method) or IV administration of iron may be
prescribed in severe cases of anemia.
4. Teach clients how to administer the iron supplements.
a. Take between meals for maximum
absorption.
b. Take with a multivitamin or fruit juice,
because vitamin C increases
absorption.
c. Do not take with milk or antacids,
because these items decrease
absorption.
d. Instruct the client about the side effects
of iron supplements (black stools,
constipation, and foul aftertaste).
e. Liquid iron preparations stains the
teeth. Teach the client that liquid iron
should be taken through a straw and
that the teeth should be brushed after
administration.
XXVIII. Vitamin B Deficiency Anemia
12
A. Description
1. A macrocytic anemia that results from an inadequate
intake of vitamin B or lack of absorption of ingested
12
vitamin B from the intestinal tract.
12
2. Pernicious anemia results from a deficiency of intrinsic
factor (normally secreted by the gastric mucosa),
necessary for intestinal absorption of vitamin B ;
12
gastric disease or surgery can result in a lack of
intrinsic factor.
B. Assessment
1. Severe pallor
2. Fatigue
3. Weight loss
4. Smooth, beefy red tongue
5. Slight jaundice
6. Paresthesias of the hands and feet

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