A nurse is assessing a client with suspected iron-deficiency anemia.
The client reports feeling fatigued and weak.
Which of the following clinical manifestations are consistent with iron-deficiency anemia in this client?
"My tongue has been inflamed lately.”
"I have a craving for ice all the time.”
"I've been experiencing chest pain.”
"I often faint when I stand up.”
Correct Answer : A,B
Choice A rationale:
"My tongue has been inflamed lately." Inflammation of the tongue, a condition known as glossitis, can be a clinical manifestation of iron-deficiency anemia.
When the body lacks sufficient iron, it may not produce enough hemoglobin, which can lead to changes in the appearance and texture of the tongue.
Glossitis can cause the tongue to become red, swollen, and sore.
This symptom is consistent with iron-deficiency anemia.
Choice B rationale:
"I have a craving for ice all the time." Pica, which involves cravings for non-nutritive substances like ice, is a classic symptom of iron-deficiency anemia.
While the exact cause of pica in iron deficiency is not fully understood, it is considered a manifestation of the body's attempt to obtain more iron.
This unusual craving for ice or other non-food items is a significant indicator of iron-deficiency anemia.
Choice C rationale:
"I've been experiencing chest pain." Chest pain is not a typical manifestation of iron-deficiency anemia.
Instead, it may be associated with other cardiovascular or respiratory conditions.
Iron-deficiency anemia primarily affects the blood's oxygen-carrying capacity and may lead to symptoms such as fatigue, pallor, weakness, and shortness of breath, but chest pain is not a direct consequence of this type of anemia.
Choice D rationale:
"I often faint when I stand up." Fainting upon standing up may be indicative of orthostatic hypotension, which can occur in various medical conditions but is not a specific symptom of iron-deficiency anemia.
Iron-deficiency anemia can lead to weakness and dizziness, but fainting when changing positions may suggest other factors, such as blood pressure regulation issues.
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Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Elevated serum iron levels are not consistent with iron-deficiency anemia.
Iron-deficiency anemia is characterized by low serum iron levels, as the body lacks sufficient iron to produce hemoglobin.
In this case, the client mentions that their serum iron levels are within the normal range, which does not align with the typical findings of iron-deficiency anemia.
Choice B rationale:
Transferrin saturation measures the amount of iron bound to transferrin in the blood.
In iron-deficiency anemia, transferrin saturation is typically below 20% because there is insufficient iron available for binding to transferrin.
Therefore, the statement that "My transferrin saturation is above 20%" is inconsistent with the diagnosis of iron-deficiency anemia.
Choice C rationale:
Serum ferritin is a key indicator of iron stores in the body.
In iron-deficiency anemia, serum ferritin levels are significantly decreased because the body has depleted its iron stores to maintain essential functions like hemoglobin synthesis.
Therefore, the statement "My serum ferritin is significantly elevated" contradicts the typical laboratory findings of iron-deficiency anemia.
Choice D rationale:
The mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC) are both red blood cell indices.
In iron-deficiency anemia, these indices are often decreased, resulting in microcytic (small) and hypochromic (pale) red blood cells.
Therefore, the statement "My MCV and MCHC are both within the normal range" does not align with the characteristic findings of iron-deficiency anemia.
Correct Answer is C
Explanation
Choice A rationale:
Iron deficiency Iron deficiency anemia is characterized by a decrease in the body's iron stores, which results in reduced hemoglobin synthesis and decreased oxygen-carrying capacity of red blood cells (RBCs)
This condition is typically caused by insufficient dietary iron intake, malabsorption of iron, or blood loss, but it does not involve increased RBC destruction.
Therefore, iron deficiency is not the correct choice for the cause of anemia in this client.
Choice B rationale:
Vitamin B12 deficiency Vitamin B12 deficiency can lead to a type of anemia known as megaloblastic anemia, which is characterized by larger-than-normal RBCs and inadequate hemoglobin production.
However, this condition is not typically associated with increased RBC destruction.
Vitamin B12 deficiency anemia is usually caused by inadequate dietary intake, malabsorption, or certain medical conditions affecting vitamin B12 absorption, but it does not fit the scenario described in the question.
Therefore, vitamin B12 deficiency is not the correct choice for the cause of anemia in this client.
Choice C rationale:
Autoimmune disease (Correct Choice) Autoimmune diseases can lead to hemolytic anemias, a group of disorders characterized by the premature destruction of RBCs by the immune system.
In these conditions, the immune system mistakenly recognizes RBCs as foreign invaders and targets them for destruction.
This process results in anemia due to increased RBC destruction.
Conditions such as autoimmune hemolytic anemia (AIHA) and autoimmune thrombocytopenic purpura (ITP) are examples of autoimmune diseases that can cause hemolytic anemia.
Therefore, autoimmune disease is the correct choice for the cause of anemia in this client.
Choice D rationale:
Bone marrow disorder Bone marrow disorders, such as aplastic anemia or myelodysplastic syndrome, can lead to anemia by affecting the production of RBCs in the bone marrow.
However, these disorders do not typically involve increased RBC destruction.
Instead, they result in a decreased production of RBCs, leading to anemia.
Therefore, a bone marrow disorder is not the correct choice for the cause of anemia in this client.
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