Anemias: Nutritional Deficiency Exemplars

anemia

Impaired production, active loss, or destruction of Red Blood Cells (RBCs).

(Decreased RBC)

anemia manifestations

Manifestations

Fatigue (1st sign), pallor, weakness, increased heart rate, and shortness of breath (SOB). In peds, can present as irritability

anemia treatment

correcting deficiencies

iron, b12, folic

pharmacologic

blood transfusion

iron deficiency

<hgb/hct, iron level

Persistent bleeding (menstruation), increased need (pregnancy), or nutritional deficit.

Pica (craving/eating non-food items like clay, paper, paste).

iron deficiency treatment

Dietary changes; Iron supplements (Ferrous sulfate/Sodium ferric gluconate);

Blood transfusions (if Hgb is low, typically below 7-8).

erythropoietin therapy

b12 deficiency

Lack of B12 or intrinsic factor necessary for absorption (e.g., after gastrectomy).

<hgb/hct levels

positive shilling test

b12 deficiency manifestations

Sore mouth and tongue.

Anorexia, diarrhea

Neurological symptoms (Paresthesia/peripheral neuropathy in hands and feet, confusion, personality changes, or "megaloblastic madness").

b12 deficiency treatment

B12 replacement (oral, but parenteral is needed if absorption is the issue, such as post-gastrectomy)

folic acid deficiency

Nutritional deficits (often associated with alcoholism), and some medications.

Occurs when the body does not have enough folate

low hgb/hct, low serum folate levels

bone marrow aspiration to confirm

folic acid deficiency manifestations

Thin, pale, emaciated appearance, Shortness of breath(rbcs are impacted).

folic acid deficiency treatment

Folic Acid supplementation, often with Vitamin C (synergistic) - helps with absorption

general anemia interventions

Energy Conservation: Assist patient with activity and provide frequent rest periods.

Oxygenation: Apply oxygen as needed/prescribed.

Nutrition: Educate patient on Iron/B12/Folic acid-rich foods.

iron

green leafy vegetables

animal protein

b12

fish

fruits

vegetables

folic acid

citrus fruits

dark leafy greens