Week 7 Discussion.docx - Week 7 Discussion Iron Deficiency...

Week 7 Discussion
Iron Deficiency Anemia
Iron deficiency anemia (IDA) is a microcytic-hypochromic anemia that occurs
worldwide and is the most common type of anemia (Schwartz, McCance, & Rote, 2017).
Absolute and functional IDA are the two main types. Absolute IDA occurs when total body iron
stores are low or depleted and functional IDA has normal iron stores but the supply to the bone
marrow is insufficient (Lopez, Cacoub, Macdougall, & Peyrin-Biroulet, 2016). Iron is an
important element of hemoglobin and myoglobin (Lopez et al., 2016). Iron is required for
numerous cellular mechanisms such as enzymatic processes, DNA synthesis, and mitochondrial
energy generation (Lopez et al., 2016). Schwartz et al. (2017) describe three overlapping stages
for IDA development. The first stage involves the depletion of the body’s iron stores for red
blood cell (RBC) production and hemoglobin synthesis. However, the production of red cells and
the hemoglobin content remain normal (Schwartz et al., 2017). In the second stage, iron-
deficient red cell production begins due to the inadequate iron transported to the bone marrow
(Schwartz et al., 2017). The deficient red cells enter circulation to replace the standard, old red
blood cells, signaling stage III development (Schwartz et al., 2017). Compensatory changes
occur when iron becomes deficient and the oxygen-carrying capacity of blood causes the tissue
to become hypoxic (Schwartz et al., 2017). Increased production of erythropoietin and a
decrease in the production of hepcidin takes place (Schrier & Auerbach, 2018). Hepcidin is a
small peptide that helps control the availability of iron to tissues (Lopez et al., 2016).
Symptoms vary depending on the severity of IDA and the milder the anemia the easier it
is for the body to compensate (Schwartz et al., 2017). Pale skin, conjunctivae, and nail beds are
some of the first symptoms to occur, along with fatigue, dyspnea on exertion evolving to
shortness of breath at rest, vertigo, syncope, headache, tachycardia, and development of a cardiac
systolic flow murmur (Lopez et al., 2016). Epithelial cells begin to become affected and rapid
turnover produces dry, rough skin, dry and damaged hair, moderate alopecia, and koilonychia
(Lopez et al., 2016). Glottis is seen in severe cases and can determine how long the iron
deficiency has occurred (Lopez et al., 2016). An esophageal web may form due to an
accumulation of mucous and inflammatory cells that has the potential to turn cancerous
(Schwartz et al., 2017).