CHAPTER 4 Hematologic System^183
- Parenteral iron replacement for those who cannot tolerate or do not respond
to oral therapy, have gastrointestinal illness, or continued bleeding:- iron dextran given deep IM or IV
- iron sodium gluconate given IV
- iron sucrose complex given IV
- IM injection of iron using Z-track method.
- Increase dietary intake of iron.
NURSING DIAGNOSES
- Imbalanced nutrition, less than what body requires
- Activity intolerance
NURSING INTERVENTION
- Monitor intake and output.
- Monitor vital signs for tachycardia or tachypnea.
- Monitor for reactions to parenteral iron therapy.
- Explain to the patient:
- Check for bleeding.
- Increase iron in diet.
- Teach dietary sources of iron.
Pernicious Anemia
WHAT WENT WRONG?
The body is unable to absorb Vitamin B 12 , which is needed to make RBC, result-
ing in a decreased RBC count. More common in people of northern European
descent, the anemia typically develops in adulthood. The intrinsic factor is nor-
mally secreted by the parietal cells of the gastric mucosa and are necessary to
allow intestinal absorption of vitamin B 12. Destruction of the gastric mucosa due
to an autoimmune response results in loss of parietal cells within the stomach. The
ability of vitamin B 12 to bind with intrinsic factor is lost, decreasing the amount
that is absorbed. Typical onset is between the ages of 40 and 60.
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