A nurse is educating a group of clients about iron-deficiency anemia.
Which of the following factors should the nurse include as potential causes of iron-deficiency anemia? (Select all that apply.)
Chronic gastrointestinal bleeding.
High serum iron levels.
Inadequate dietary intake of iron.
Elevated serum ferritin levels.
Increased erythropoietic activity.
Correct Answer : A,C,E
Choice A rationale:
Chronic gastrointestinal bleeding is a common cause of iron-deficiency anemia.
Blood loss from the gastrointestinal tract leads to the loss of iron, ultimately depleting iron stores in the body and impairing hemoglobin synthesis.
Choice B rationale:
High serum iron levels are not a potential cause of iron-deficiency anemia.
Iron-deficiency anemia is characterized by low serum iron levels, as the body lacks sufficient iron to produce hemoglobin.
Choice C rationale:
Inadequate dietary intake of iron can lead to iron-deficiency anemia, especially in individuals who do not consume enough iron-rich foods.
A lack of dietary iron can result in reduced iron absorption and insufficient iron stores in the body.
Choice D rationale:
Elevated serum ferritin levels are not a potential cause of iron-deficiency anemia.
In fact, elevated serum ferritin levels are more indicative of iron overload conditions rather than iron deficiency.
Choice E rationale:
Increased erythropoietic activity can be a compensatory response to iron-deficiency anemia.
When the body senses low oxygen-carrying capacity due to reduced hemoglobin levels, it may increase erythropoietin production, leading to the production of more red blood cells (erythropoiesis) in an attempt to improve oxygen delivery to tissues.
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Correct Answer is C
Explanation
Choice A rationale:
High serum iron levels and low total iron-binding capacity (TIBC) are not indicative of iron-deficiency anemia.
In this scenario, elevated serum iron levels contradict the typical finding of low serum iron levels in iron-deficiency anemia.
Choice B rationale:
High mean corpuscular volume (MCV) and high mean corpuscular hemoglobin (MCH) are not consistent with the characteristic findings of iron-deficiency anemia.
Iron-deficiency anemia typically results in microcytic (small) and hypochromic (pale) red blood cells, leading to low MCV and low MCH.
Choice C rationale:
Low hemoglobin and low hematocrit are consistent with the diagnosis of iron-deficiency anemia.
In this condition, there is insufficient iron available to produce hemoglobin, leading to decreased hemoglobin levels and reduced hematocrit.
Choice D rationale:
Elevated mean corpuscular hemoglobin concentration (MCHC) and low red cell distribution width (RDW) are not typical findings of iron-deficiency anemia.
Iron-deficiency anemia is characterized by hypochromic (pale) red blood cells and often results in increased RDW due to variability in red cell size (anisocytosis)
Elevated MCHC is not expected in 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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